Provider Demographics
NPI:1316464563
Name:ZELIE, JONNA M (PA-C)
Entity type:Individual
Prefix:
First Name:JONNA
Middle Name:M
Last Name:ZELIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JONNA
Other - Middle Name:
Other - Last Name:SCHAPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:395 WEST AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1548
Mailing Address - Country:US
Mailing Address - Phone:585-486-0901
Mailing Address - Fax:585-940-5399
Practice Address - Street 1:125 LATTIMORE RD STE G-110
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4159
Practice Address - Country:US
Practice Address - Phone:585-486-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021278363AM0700X
NY21278363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical