Healthcare Provider Details

I. General information

NPI: 1487612701
Provider Name (Legal Business Name): LOUIS F CERAMI RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-8353
  • Fax: 585-922-0572
Mailing address:
  • Phone: 585-922-8353
  • Fax: 585-922-0572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number002270
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0022701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: