National Provider Identifier

Carol Diane Fague, RPA-C

Carol Diane Fague, 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) 341-6880.

NPI 1851528798Rochester, NYMedical Physician Assistant

Profile Overview

NPI
1851528798
Provider Type
Individual
Primary Specialty
Medical Physician Assistant
Enumeration Date
June 18, 2009
Last Updated
September 26, 2011

Practice Location

  • 1000 South Ave
  • Rochester, NY 14620-2733

Phone: (585) 341-6880

Mailing Address

  • 601 Elmwood Ave
  • Box 655
  • Rochester, NY 14642-8655

Specialties

  • Medical Physician Assistant (363AM0700X)
Full Record
NPI
1851528798
Entity Type
Individual
Last Name
Fague
First Name
Carol
Middle Name
Diane
Name Prefix
Miss
Credential
RPA-C
Mailing Street Address
601 Elmwood Ave
Mailing Address Line 2
Box 655
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-8655
Mailing Country
US
Mailing Phone
(585) 341-6880
Practice Street Address
1000 South Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14620-2733
Practice Country
US
Practice Phone
(585) 341-6880
Enumeration Date
June 18, 2009
Last Updated
September 26, 2011
Sex
Female
Sole Proprietor
No
Taxonomies
Medical Physician Assistant (363AM0700X)