Provider Demographics
NPI:1245743103
Name:OZOG, PATRICIA STEGMAN (PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:STEGMAN
Last Name:OZOG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LINDEN OAKS STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2899
Mailing Address - Country:US
Mailing Address - Phone:724-961-9241
Mailing Address - Fax:
Practice Address - Street 1:220 LINDEN OAKS STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2839
Practice Address - Country:US
Practice Address - Phone:585-381-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026284363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical