National Provider Identifier

Marley Jane Wahl

Marley Jane Wahl is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 922-9080.

NPI 1861910697Rochester, NYPhysician Assistant

Profile Overview

NPI
1861910697
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
August 31, 2017
Last Updated
August 14, 2024

Practice Location

  • 1425 Portland Ave
  • Rochester, NY 14621-3001

Phone: (585) 922-9080

Mailing Address

  • 689 Gillett RD
  • Rochester, NY 14624-1036

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1861910697
Entity Type
Individual
Last Name
Wahl
First Name
Marley
Middle Name
Jane
Mailing Street Address
689 Gillett RD
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14624-1036
Mailing Country
US
Mailing Phone
(607) 972-8591
Practice Street Address
1425 Portland Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3001
Practice Country
US
Practice Phone
(585) 922-9080
Enumeration Date
August 31, 2017
Last Updated
August 14, 2024
Sex
Female
Sole Proprietor
No
Certification Date
August 14, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)