National Provider Identifier
Shannon Derose, RPA-C
Shannon Derose, RPA-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) 723-7600.
Profile Overview
- NPI
- 1407004898
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- August 28, 2008
- Last Updated
- September 14, 2022
Practice Location
- 125 Red Creek Dr Ste 205
- Rochester, NY 14623-4262
Phone: (585) 723-7600
Mailing Address
- 1555 Long Pond RD
- Rochester, NY 14626-4122
Specialties
- Surgical Physician Assistant (363AS0400X)
Endpoints
- shannon.derose@rochesterregional.org
Direct Messaging Address | Rochester, NY 14621
Full Record
- NPI
- 1407004898
- Entity Type
- Individual
- Last Name
- Derose
- First Name
- Shannon
- Credential
- RPA-C
- Provider Other Last Name
- Parker
- Provider Other First Name
- Shannon
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 1555 Long Pond RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14626-4122
- Mailing Country
- US
- Mailing Phone
- (585) 723-7281
- Mailing Fax
- (585) 723-8660
- Practice Street Address
- 125 Red Creek Dr Ste 205
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14623-4262
- Practice Country
- US
- Practice Phone
- (585) 723-7600
- Practice Fax
- (585) 334-6373
- Enumeration Date
- August 28, 2008
- Last Updated
- September 14, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 14, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X)
- Other Identifiers
- 03607632 (NY)