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NPI Code Detail

MEDICARE: ABBY SUE KOHL PA-C

MEDICARE: ABBY SUE KOHL 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 Assistant030239NY
2363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1508331083
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBY SUE KOHL 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 : 585-922-1900
Fax Number : 585-922-1002
Provider Business Practice Location Address
First Line : 50 MIDDLE RD
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9312
Country : US
Telephone Number : 585-723-7600
Fax Number : 585-334-6373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2018
Last Update Date : 08/05/2025

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Directions to “ ABBY SUE KOHL PA-C” Practice Location

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