Individual
MS. KATHLEEN ANN O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1445 PORTLAND AVENUE , SUITE 108, ROCHESTER, NY 14621
(585) 922-5550
(585) 922-5950
Mailing address
1445 PORTLAND AVENUE , SUITE 108, ROCHESTER, NY 14621
(585) 922-5550
(585) 922-5950
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009482
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292385800
—
FL
Enumeration date
08/30/2006
Last updated
08/20/2019
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