Provider Demographics
NPI:1003217431
Name:BRESCIA, NICOLE (RPA-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BRESCIA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2604
Mailing Address - Country:US
Mailing Address - Phone:585-338-1200
Mailing Address - Fax:585-544-1359
Practice Address - Street 1:800 CARTER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2604
Practice Address - Country:US
Practice Address - Phone:585-338-1200
Practice Address - Fax:585-544-1359
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17841363A00000X
NY017841-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant