National Provider Identifier
Elizabeth Supra, M.D.
Elizabeth Supra, M.D. is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Rochester, NY and a listed phone number of (585) 256-2210.
Profile Overview
- NPI
- 1942350350
- Provider Type
- Individual
- Primary Specialty
- Pediatrics Physician
- Enumeration Date
- January 11, 2007
- Last Updated
- July 08, 2007
Practice Location
- 2225 Clinton Ave S
- Rochester, NY 14618-2623
Phone: (585) 256-2210
Mailing Address
- 17 Stonebridge Lane
- Pittsford, NY 14534
Specialties
- Pediatrics Physician (208000000X)
Full Record
- NPI
- 1942350350
- Entity Type
- Individual
- Last Name
- Supra
- First Name
- Elizabeth
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 17 Stonebridge Lane
- Mailing City
- Pittsford
- Mailing State
- NY
- Mailing ZIP Code
- 14534
- Mailing Country
- US
- Practice Street Address
- 2225 Clinton Ave S
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14618-2623
- Practice Country
- US
- Practice Phone
- (585) 256-2210
- Enumeration Date
- January 11, 2007
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatrics Physician (208000000X)