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ROSA CANNATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
5898 BRIDGE ST, EAST SYRACUSE, NY 13057
(315) 663-0112
Mailing address
5898 BRIDGE ST, EAST SYRACUSE, NY 13057
(315) 663-0112

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009113
NY
363AS0400X
Surgical Physician Assistant
009113
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009113
LICENSE
NY
05
02625978
NY
Enumeration date
06/16/2005
Last updated
05/15/2020
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