Provider Demographics
NPI:1306958046
Name:PRINZING, MARY ELLEN (PA)
Entity type:Individual
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First Name:MARY
Middle Name:ELLEN
Last Name:PRINZING
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1573 ELMWOOD AVE
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3619
Mailing Address - Country:US
Mailing Address - Phone:585-273-1636
Mailing Address - Fax:585-276-2212
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX MED-HMD
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-273-1636
Practice Address - Fax:585-276-2212
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-07-05
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Provider Licenses
StateLicense IDTaxonomies
NY10916363A00000X
NY010916363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant