National Provider Identifier

Katie Elizabeth Dimartino, PA

Katie Elizabeth Dimartino, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 723-7060.

NPI 1225385305Rochester, NYSurgical Physician Assistant

Profile Overview

NPI
1225385305
Provider Type
Individual
Primary Specialty
Surgical Physician Assistant
Enumeration Date
August 08, 2012
Last Updated
April 17, 2023

Practice Location

  • 2655 Ridgeway Ave Ste 240
  • Rochester, NY 14626-4296

Phone: (585) 723-7060

Specialties

  • Surgical Physician Assistant (363AS0400X)
Full Record
NPI
1225385305
Entity Type
Individual
Last Name
Dimartino
First Name
Katie
Middle Name
Elizabeth
Credential
PA
Provider Other Last Name
Kenny
Provider Other First Name
Katie
Provider Other Middle Name
Elizabeth
Provider Other Credential Text
PA
Provider Other Last Name Type Code
1
Mailing Street Address
2655 Ridgeway Ave Ste 240
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14626-4296
Mailing Country
US
Mailing Phone
(585) 723-7060
Mailing Fax
(585) 723-7325
Practice Street Address
2655 Ridgeway Ave Ste 240
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626-4296
Practice Country
US
Practice Phone
(585) 723-7060
Practice Fax
(585) 723-7325
Enumeration Date
August 08, 2012
Last Updated
April 17, 2023
Sex
Female
Sole Proprietor
No
Certification Date
April 17, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Surgical Physician Assistant (363AS0400X)
Other Identifiers
03524476 (NY), 12434137 (NY, Caqh)