Provider Demographics
NPI:1114994159
Name:WHITE, KRISTINE L (PA)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E. HENRIETTA RD.
Mailing Address - Street 2:STRONG HEALTH GERIATRICS
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4629
Mailing Address - Country:US
Mailing Address - Phone:585-760-5466
Mailing Address - Fax:585-760-5467
Practice Address - Street 1:1000 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2733
Practice Address - Country:US
Practice Address - Phone:585-473-2200
Practice Address - Fax:585-271-4489
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3615363AM0700X
NY003615363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400027498Medicare PIN
NYJ400027497Medicare PIN
NYJ400022003Medicare PIN
NYJ400022005Medicare PIN