Individual
VICTORIA ROSE UTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3456
Mailing address
67 NORTHRIDGE DR, WEST SENECA, NY 14224-4408
(716) 997-5776
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
025514
NY
363AM0700X
Medical Physician Assistant
Primary
025514
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025514
NEW YORK STATE LICENSURE
NY
Enumeration date
11/23/2020
Last updated
02/25/2022
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