Individual
KATHARINA MARIAH INDIVERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1445 PORTLAND AVE STE 108, ROCHESTER, NY 14621-3008
(585) 922-5550
(585) 922-5950
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-5550
(585) 922-5950
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018882
NY
Other
Enumeration date
08/24/2015
Last updated
01/28/2021
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