National Provider Identifier

Josiah James Surbatovich, PHYSICIAN ASSISTANT

Josiah James Surbatovich, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Brockport, NY and a listed phone number of (585) 395-6052.

NPI 1275045791Brockport, NYMedical Physician Assistant

Profile Overview

NPI
1275045791
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
October 25, 2017
Last Updated
January 30, 2018

Practice Location

  • 170 West Ave
  • Brockport, NY 14420-1227

Phone: (585) 395-6052

Mailing Address

  • 105 Canal Landing Blvd Ste 1
  • Rochester, NY 14626-5107

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1275045791
Entity Type
Individual
Last Name
Surbatovich
First Name
Josiah
Middle Name
James
Credential
PHYSICIAN ASSISTANT
Mailing Street Address
105 Canal Landing Blvd Ste 1
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14626-5107
Mailing Country
US
Mailing Phone
(585) 368-4050
Mailing Fax
(585) 723-6705
Practice Street Address
170 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1227
Practice Country
US
Practice Phone
(585) 395-6052
Practice Fax
(585) 395-6007
Enumeration Date
October 25, 2017
Last Updated
January 30, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X)