Individual
MICHELLE LYNN FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-4020
(585) 922-4622
Mailing address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-4020
(585) 922-4622
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011320-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379650
—
NY
Enumeration date
02/21/2008
Last updated
09/22/2022
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