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General NPI Number Information
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NPI Number | 1851736060
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Entity Type | Individual
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Provider Name | ABBY GOERGEN PA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 2250 BRIGHTON HENRIETTA TOWN LINE RD
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City | ROCHESTER
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State | NY
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Zip | 14623-2706
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Country | US
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Telephone | 585-424-6770
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Fax | 585-424-6776
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Provider Business Mailing Address
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Address Line | 100 KINGS HWY S
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City | ROCHESTER
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State | NY
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Zip | 14617-5504
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Country | US
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Telephone | 585-424-6770
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Fax | 585-424-6776
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 4755
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 025035
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License Number State | NY
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