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General NPI Number Information
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NPI Number | 1346477429
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Entity Type | Individual
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Provider Name | ANGELA M. ST CLAIR D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 300 RED CREEK DR SUITE 200
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City | ROCHESTER
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State | NY
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Zip | 14623-4283
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Country | US
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Telephone | 585-487-2221
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Fax | 585-334-8732
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE BOX 278980
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-487-2221
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Fax | 585-334-8732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125056825
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 272444
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License Number State | NY
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