National Provider Identifier

Shani A Wilson, RPA-C

Shani A Wilson, RPA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Rochester, NY and a listed phone number of (585) 368-4500.

NPI 1477989580Rochester, NYMedical Physician Assistant

Profile Overview

NPI
1477989580
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
September 20, 2013
Last Updated
December 02, 2020

Practice Location

  • 158 Orchard St
  • Rochester, NY 14611-1361

Phone: (585) 368-4500

Mailing Address

  • 82 Holland St
  • Rochester, NY 14605-2199

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1477989580
Entity Type
Individual
Last Name
Wilson
First Name
Shani
Middle Name
A
Credential
RPA-C
Mailing Street Address
82 Holland St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14605-2199
Mailing Country
US
Mailing Phone
(585) 368-4500
Mailing Fax
(585) 436-6047
Practice Street Address
158 Orchard St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14611-1361
Practice Country
US
Practice Phone
(585) 368-4500
Practice Fax
(585) 436-6047
Enumeration Date
September 20, 2013
Last Updated
December 02, 2020
Sex
Female
Sole Proprietor
No
Certification Date
November 16, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X)
Other Identifiers
03743464 (NY)