Healthcare Provider Details

I. General information

NPI: 1316963440
Provider Name (Legal Business Name): TERRI RAGIN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 LOMB MEMORIAL DR STE 78-A670
ROCHESTER NY
14623-5690
US

IV. Provider business mailing address

100 KINGS HWY S STE 1400
ROCHESTER NY
14617-5541
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-3100
  • Fax: 585-922-3109
Mailing address:
  • Phone: 585-922-1203
  • Fax: 585-922-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number010701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: