National Provider Identifier

Donovan Jacob Rose, PA-C

Donovan Jacob Rose, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 276-0830.

NPI 1558045856Rochester, NYPhysician Assistant

Profile Overview

NPI
1558045856
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
June 15, 2023
Last Updated
March 20, 2024

Practice Location

  • 1870 Winton RD S Ste 100
  • Rochester, NY 14618-4011

Phone: (585) 276-0830

Specialties

  • Physician Assistant (363A00000X)
  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1558045856
Entity Type
Individual
Last Name
Rose
First Name
Donovan
Middle Name
Jacob
Credential
PA-C
Mailing Street Address
1870 Winton RD S Ste 100
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14618-4011
Mailing Country
US
Mailing Phone
(585) 276-0830
Practice Street Address
1870 Winton RD S Ste 100
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14618-4011
Practice Country
US
Practice Phone
(585) 276-0830
Enumeration Date
June 15, 2023
Last Updated
March 20, 2024
Sex
Male
Sole Proprietor
No
Certification Date
March 19, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Medical Physician Assistant (363AM0700X)