Healthcare Provider Details

I. General information

NPI: 1548299316
Provider Name (Legal Business Name): MICHELLE P CILENTO RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LINDEN OAKS STE 300
ROCHESTER NY
14625-2839
US

IV. Provider business mailing address

68 LANCER PL
WEBSTER NY
14580-4308
US

V. Phone/Fax

Practice location:
  • Phone: 585-383-4420
  • Fax: 585-383-4515
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number006850-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number006850
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number006850
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: