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Individual

ALICIA WESSON-ROTH HOLTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1425 PORTLAND AVE, BOX 362, ROCHESTER, NY 14621-3001
(585) 922-2906
(585) 922-2951
Mailing address
1425 PORTLAND AVE, BOX 362, ROCHESTER, NY 14621-3001
(585) 922-2906
(585) 922-2951

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
016953
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03693941
NY
05
J400098053
NY
Enumeration date
09/16/2013
Last updated
01/24/2014
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