Provider Demographics
NPI:1689602955
Name:MAROWSKI, DEBRA ANN (PA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:MAROWSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1555 LONG POND RD
Mailing Address - Street 2:DEPT OF SURGERY
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4122
Mailing Address - Country:US
Mailing Address - Phone:585-723-7281
Mailing Address - Fax:585-723-8660
Practice Address - Street 1:1555 LONG POND RD
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:585-723-7281
Practice Address - Fax:585-723-8660
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004000363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01992658Medicaid
NYBB7723-GRP:70008AMedicare PIN
NYPA0041-GRP:BA0017Medicare PIN
NYBB7723-GRP:70008AMedicare PIN