Individual
EMILY A BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 723-7281
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 368-4788
(585) 723-7280
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
115111
NY
363AS0400X
Surgical Physician Assistant
Primary
015111
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05632233
—
NY
01
—
P01035984
MEDICARE RR
NY
Enumeration date
09/15/2011
Last updated
04/29/2022
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