Individual
JORDAN ELIZABETH EVANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-5647
(585) 275-9555
Mailing address
601 ELMWOOD AVE BOX 655, ROCHESTER, NY 14642-8655
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
18081
NY
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/12/2014
Last updated
08/04/2025
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