National Provider Identifier

Cody Donald Sponholz

Cody Donald Sponholz is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Geneva, NY and a listed phone number of (315) 789-5061.

NPI 1134795685Geneva, NYSurgical Physician Assistant

Profile Overview

NPI
1134795685
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
June 03, 2021
Last Updated
November 22, 2021

Practice Location

  • 875 Pre Emption RD
  • Geneva, NY 14456-2042

Phone: (315) 789-5061

Mailing Address

  • 100 Kings Hwy S
  • Rochester, NY 14617-5504

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1134795685
Entity Type
Individual
Last Name
Sponholz
First Name
Cody
Middle Name
Donald
Name Prefix
Mr.
Mailing Street Address
100 Kings Hwy S
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-5504
Mailing Country
US
Mailing Phone
(315) 789-5061
Practice Street Address
875 Pre Emption RD
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456-2042
Practice Country
US
Practice Phone
(315) 789-5061
Enumeration Date
June 03, 2021
Last Updated
November 22, 2021
Sex
Male
Sole Proprietor
Yes
Certification Date
November 22, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)