Individual provider · Type 1 NPI

Shannon Derose, RPA-C

Surgical Physician Assistant · Rochester, NY

NPI number 1407004898 Active

Practice location

125 Red Creek Dr Ste 205
Rochester, NY 14623-4262

Call (585) 723-7600 Map

Fax (585) 334-6373

Mailing address

1555 Long Pond Rd
Rochester, NY 14626-4122

Other practice locations

  • 2115 Chili Ave, Rochester, NY 14624-3425 · (585) 723-7600

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X012694 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1407004898

Shannon Derose, RPA-C's National Provider Identifier is 1407004898, issued on Aug 28, 2008. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Rochester, NY. The record was last updated on Sep 14, 2022.