Provider Demographics
NPI:1215962246
Name:COTTLE, MARK F (RPA C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:F
Last Name:COTTLE
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Gender:M
Credentials:RPA C
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Mailing Address - Street 1:30 HAGEN DRIVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2658
Mailing Address - Country:US
Mailing Address - Phone:585-295-5314
Mailing Address - Fax:585-248-2112
Practice Address - Street 1:30 HAGEN DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2658
Practice Address - Country:US
Practice Address - Phone:585-295-5314
Practice Address - Fax:585-248-2112
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG0185663590OtherPREFERRED CARE
CC3943Medicare ID - Type Unspecified
R58006Medicare UPIN