Individual
LAURA CONVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2212 PENFIELD RD, SUITE 200, PENFIELD, NY 14526-1756
(585) 598-8567
(585) 388-1483
Mailing address
601 ELMWOOD AVE, BOX 278980, ROCHESTER, NY 14642-0001
(585) 598-8567
(585) 388-1483
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
14960
NY
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03368045
—
NY
Enumeration date
07/25/2011
Last updated
03/21/2023
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