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NPI Code Detail

MEDICARE: POONAM RAMSDELL PA-C

MEDICARE: POONAM RAMSDELL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant024764NY
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1467918250
Entity Type Code : Individual
Provider Name (Legal Business Name) : POONAM RAMSDELL PA-C
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-922-4136
Fax Number :
Provider Business Practice Location Address
First Line : 1304 DRIVING PARK AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-1059
Country : US
Telephone Number : 315-359-2670
Fax Number : 315-359-2675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2019
Last Update Date : 01/02/2025

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Directions to “ POONAM RAMSDELL PA-C” Practice Location

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