National Provider Identifier

Emily Grace Domina, PA-C

Emily Grace Domina, PA-C is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 723-7000.

NPI 1215706312Rochester, NYSurgical Physician Assistant

Profile Overview

NPI
1215706312
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
December 29, 2023
Last Updated
December 29, 2023

Practice Location

  • 1555 Long Pond RD
  • Rochester, NY 14626-4164

Phone: (585) 723-7000

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1215706312
Entity Type
Individual
Last Name
Domina
First Name
Emily
Middle Name
Grace
Credential
PA-C
Provider Other Last Name
Coles
Provider Other First Name
Emily
Provider Other Middle Name
Grace
Provider Other Last Name Type Code
1
Mailing Street Address
1555 Long Pond RD
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14626-4164
Mailing Country
US
Practice Street Address
1555 Long Pond RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626-4164
Practice Country
US
Practice Phone
(585) 723-7000
Enumeration Date
December 29, 2023
Last Updated
December 29, 2023
Sex
Female
Sole Proprietor
No
Certification Date
December 23, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)