Individual
BETHANY LYN LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
160 SAWGRASS DR, ROCHESTER, NY 14620-4656
(585) 262-9150
Mailing address
318 EMBURY RD, ROCHESTER, NY 14625-1150
(585) 410-2736
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
348131
NY
363LF0000X
Family Nurse Practitioner
Primary
348131
NY
Other
Enumeration date
08/16/2021
Last updated
07/07/2023
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