Individual
RACHAEL WIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-4000
Mailing address
783 POST AVE, ROCHESTER, NY 14619-2309
(585) 469-8697
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015821
NY
Other
Enumeration date
07/27/2012
Last updated
11/05/2018
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