Healthcare Provider Details

I. General information

NPI: 1295983963
Provider Name (Legal Business Name): ASHLEIGH L RAUSCH RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEIGH L MATTESON

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 W MAIN ST
WEBSTER NY
14580-2700
US

IV. Provider business mailing address

191 W MAIN ST
WEBSTER NY
14580-2700
US

V. Phone/Fax

Practice location:
  • Phone: 315-272-8721
  • Fax: 800-863-0275
Mailing address:
  • Phone: 315-272-8721
  • Fax: 800-863-0275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number012740
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: