Individual
MS. ALESHA J PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3 LYON PL STE 303, OGDENSBURG, NY 13669-2546
(315) 713-6700
(866) 816-0815
Mailing address
3 LYON PL STE 303, OGDENSBURG, NY 13669-2546
(315) 713-6700
(866) 816-0815
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0010-02901
NC
363AM0700X
Medical Physician Assistant
Primary
014198
NY
363AM0700X
Medical Physician Assistant
P76871
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03272608
—
NY
Enumeration date
08/09/2010
Last updated
09/12/2022
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