Individual provider · Type 1 NPI

Jordan Elizabeth Evanicki, PA-C

Medical Physician Assistant · Rochester, NY

NPI number 1679974372 Active

Practice location

601 Elmwood Ave
Rochester, NY 14642-5647

Call (585) 275-9555 Map

Mailing address

601 Elmwood Ave Box 655
Rochester, NY 14642-8655

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X18081 (NY)
Medical Physician Assistant Primary 363AM0700XNone listed

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About NPI 1679974372

Jordan Elizabeth Evanicki, PA-C's National Provider Identifier is 1679974372, issued on Sep 12, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rochester, NY. The record was last updated on Aug 4, 2025.