Individual
MR. ALLEN PAUL WILLISTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1000 SOUTH AVE, ROCHESTER, NY 14620-2733
(585) 473-2200
Mailing address
1000 SOUTH AVE, ROCHESTER, NY 14620-2733
(585) 473-2200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001356-1
NY
Other
Enumeration date
07/18/2006
Last updated
07/08/2007
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