National Provider Identifier

Lydia M Prospero, PA-C

Lydia M Prospero, PA-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) 244-3430.

NPI 1740742980Rochester, NYMedical Physician Assistant

Profile Overview

NPI
1740742980
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
April 05, 2019
Last Updated
April 10, 2025

Practice Location

  • 777 Canal View Blvd
  • Rochester, NY 14623-2825

Phone: (585) 244-3430

Specialties

  • Medical Physician Assistant (363AM0700X)
  • Medical Physician Assistant (363AM0700X)

Endpoints

  • lstout183292@direct.urmc.rochester.edu

    Direct Messaging Address | Direct | Other | Rochester, NY 14642

Full Record
NPI
1740742980
Entity Type
Individual
Last Name
Prospero
First Name
Lydia
Middle Name
M
Credential
PA-C
Provider Other Last Name
Stout
Provider Other First Name
Lydia
Provider Other Middle Name
M
Provider Other Credential Text
PA-C
Provider Other Last Name Type Code
1
Mailing Street Address
777 Canal View Blvd
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14623-2825
Mailing Country
US
Mailing Phone
(585) 244-3430
Practice Street Address
777 Canal View Blvd
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14623-2825
Practice Country
US
Practice Phone
(585) 244-3430
Enumeration Date
April 05, 2019
Last Updated
April 10, 2025
Sex
Female
Sole Proprietor
No
Certification Date
April 10, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Medical Physician Assistant (363AM0700X), Medical Physician Assistant (363AM0700X)