Provider Demographics
NPI:1275378275
Name:ZICARI, CHARLEY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:CHARLEY
Middle Name:ELIZABETH
Last Name:ZICARI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 TRAYMORE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-5801
Mailing Address - Country:US
Mailing Address - Phone:315-608-0047
Mailing Address - Fax:
Practice Address - Street 1:23 TRAYMORE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-5801
Practice Address - Country:US
Practice Address - Phone:315-608-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant