Provider Demographics
NPI:1467948133
Name:BREWSTER, NATALIE SUZANNE (PA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:SUZANNE
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:SUZANNE
Other - Last Name:GARRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
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:585-922-0553
Mailing Address - Fax:
Practice Address - Street 1:2066 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-4300
Practice Address - Country:US
Practice Address - Phone:585-922-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022314363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical