Provider Demographics
NPI:1164901609
Name:NEWLAND, STEFFANIE CAROL (NP)
Entity Type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:CAROL
Last Name:NEWLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STEFFANIE
Other - Middle Name:CAROL
Other - Last Name:VAVRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-1900
Mailing Address - Fax:
Practice Address - Street 1:2 COULTER RD
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1122
Practice Address - Country:US
Practice Address - Phone:315-462-9478
Practice Address - Fax:315-462-6707
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659830163W00000X
NY343411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse