Provider Demographics
NPI:1538678305
Name:BISHOP, TRICIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:
Last Name:BISHOP
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 1:100 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:585-723-7225
Mailing Address - Fax:585-723-7280
Practice Address - Street 1:1555 LONG POND ROAD
Practice Address - Street 2:DEPT. OF SURGERY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4122
Practice Address - Country:US
Practice Address - Phone:585-723-7225
Practice Address - Fax:585-723-7280
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021736363AS0400X
NJ25MP00524300363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical