Healthcare Provider Details

I. General information

NPI: 1245265594
Provider Name (Legal Business Name): MARGARET M CASPER RPAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 PORTLAND AVE STE 210
ROCHESTER NY
14621-3008
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-266-2010
  • Fax: 585-266-5363
Mailing address:
  • Phone: 585-266-2010
  • Fax: 585-266-5363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number009225
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: