National Provider Identifier
Katharina Mariah Indivero, PA-C
Katharina Mariah Indivero, 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) 922-5550.
Source: public NPPES record, last updated January 28, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1538536750
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- August 24, 2015
- Last Updated
- January 28, 2021
Practice Location
- 1445 Portland Ave Ste 108
- Rochester, NY 14621-3008
Phone: (585) 922-5550
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Surgical Physician Assistant (363AS0400X)
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Full Record
- NPI
- 1538536750
- Entity Type
- Individual
- Last Name
- Indivero
- First Name
- Katharina
- Middle Name
- Mariah
- Credential
- PA-C
- Provider Other Last Name
- Kristan
- Provider Other First Name
- Katharina
- Provider Other Middle Name
- Mariah
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 922-5550
- Mailing Fax
- (585) 922-5950
- Practice Street Address
- 1445 Portland Ave Ste 108
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3008
- Practice Country
- US
- Practice Phone
- (585) 922-5550
- Practice Fax
- (585) 922-5950
- Enumeration Date
- August 24, 2015
- Last Updated
- January 28, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 28, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X)