National Provider Identifier

Marc L Siditsky, RPA-C

Marc L Siditsky, RPA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Rochester, NY and a listed phone number of (585) 342-2638.

NPI 1972521847Rochester, NYPhysician Assistant

Profile Overview

NPI
1972521847
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
July 18, 2006
Last Updated
September 18, 2020

Practice Location

  • 1445 Portland Avenue
  • Ste 309
  • Rochester, NY 14621-3008

Phone: (585) 342-2638

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1972521847
Entity Type
Individual
Last Name
Siditsky
First Name
Marc
Middle Name
L
Credential
RPA-C
Mailing Street Address
1445 Portland Avenue
Mailing Address Line 2
Ste 309
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621-3008
Mailing Country
US
Mailing Phone
(585) 342-2638
Mailing Fax
(585) 730-7500
Practice Street Address
1445 Portland Avenue
Practice Address Line 2
Ste 309
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3008
Practice Country
US
Practice Phone
(585) 342-2638
Practice Fax
(585) 730-7500
Enumeration Date
July 18, 2006
Last Updated
September 18, 2020
Sex
Male
Sole Proprietor
No
Certification Date
September 18, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)
Other Identifiers
01272146 (NY)