Individual
MRS. MARCELLA LEE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER REGIONAL HEALTH, ROCHESTER, NY 14621
(585) 338-1200
Mailing address
1425 PORTLAND AVE, ROCHESTER REGIONAL HEALTH, ROCHESTER, NY 14621
(585) 338-1200
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018715
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04295236
—
NY
Enumeration date
07/09/2015
Last updated
03/21/2018
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