National Provider Identifier

Sophia Avery

Sophia Avery is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 723-7000.

NPI 1174167100Rochester, NYPhysician Assistant

Profile Overview

NPI
1174167100
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
November 02, 2019
Last Updated
September 13, 2021

Practice Location

  • 1555 Long Pond RD
  • Rochester, NY 14626-4122

Phone: (585) 723-7000

Mailing Address

  • 7469 W Ridge RD
  • Brockport, NY 14420-9429

Specialties

  • Physician Assistant (363A00000X)
  • Obstetrics & Gynecology Physician (207V00000X)
Full Record
NPI
1174167100
Entity Type
Individual
Last Name
Avery
First Name
Sophia
Mailing Street Address
7469 W Ridge RD
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-9429
Mailing Country
US
Mailing Phone
(585) 331-3143
Practice Street Address
1555 Long Pond RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626-4122
Practice Country
US
Practice Phone
(585) 723-7000
Enumeration Date
November 02, 2019
Last Updated
September 13, 2021
Sex
Female
Sole Proprietor
No
Certification Date
September 13, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Obstetrics & Gynecology Physician (207V00000X)