National Provider Identifier
Olivia Marie Raetz, PA
Olivia Marie Raetz, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 342-2638.
Profile Overview
- NPI
- 1205649589
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- January 30, 2025
- Last Updated
- January 30, 2025
Practice Location
- 1445 Portland Ave Ste 309
- Rochester, NY 14621-3008
Phone: (585) 342-2638
Mailing Address
- 10 Blackburn Knl
- Spencerport, NY 14559-2199
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1205649589
- Entity Type
- Individual
- Last Name
- Raetz
- First Name
- Olivia
- Middle Name
- Marie
- Credential
- PA
- Mailing Street Address
- 10 Blackburn Knl
- Mailing City
- Spencerport
- Mailing State
- NY
- Mailing ZIP Code
- 14559-2199
- Mailing Country
- US
- Mailing Phone
- (585) 471-9214
- Practice Street Address
- 1445 Portland Ave Ste 309
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3008
- Practice Country
- US
- Practice Phone
- (585) 342-2638
- Enumeration Date
- January 30, 2025
- Last Updated
- January 30, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 29, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)