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NPI Code Detail

MEDICARE: JESSICA SPEARES RPA-C

MEDICARE: JESSICA SPEARES RPA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant23014893NY

General Provider Information

NPI Number : 1861770794
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SPEARES RPA-C
Provider Business Mailing Address
First Line : 1700 HUDSON AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5155
Country : US
Telephone Number : 585-342-5665
Fax Number : 585-342-2345
Provider Business Practice Location Address
First Line : 340 ARNETT BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14619-1147
Country : US
Telephone Number : 585-235-2250
Fax Number : 585-235-0011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2011
Last Update Date : 02/01/2023

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Directions to “ JESSICA SPEARES RPA-C” Practice Location

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