Provider Demographics
NPI:1376574731
Name:SAPORITO, BRENDA (RPA-C)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SAPORITO
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 1:99 CANAL LANDING BLVD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-5112
Mailing Address - Country:US
Mailing Address - Phone:585-225-9213
Mailing Address - Fax:585-225-7490
Practice Address - Street 1:99 CANAL LANDING BLVD
Practice Address - Street 2:SUITE 10
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-5112
Practice Address - Country:US
Practice Address - Phone:585-225-9213
Practice Address - Fax:585-225-7490
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009360363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019009360OtherEXCELLUS
NY000927215001OtherHEALTHNOW
DD6812Medicare ID - Type Unspecified
NYP019009360OtherEXCELLUS