Individual
ABBY GOERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2250 BRIGHTON HENRIETTA TOWN LINE RD, ROCHESTER, NY 14623-2706
(585) 424-6770
(585) 424-6776
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 424-6770
(585) 424-6776
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
025035
NY
363AS0400X
Surgical Physician Assistant
4755
CO
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06168152
—
NY
Enumeration date
05/01/2013
Last updated
05/04/2023
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