Provider Demographics
NPI:1891087771
Name:REFFELL-PUGH, ROSAMOND M (FNP)
Entity Type:Individual
Prefix:MS
First Name:ROSAMOND
Middle Name:M
Last Name:REFFELL-PUGH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARTER STREET
Mailing Address - Street 2:LIFETIME HEALTH MEDICAL GROUP
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2607
Mailing Address - Country:US
Mailing Address - Phone:585-338-1200
Mailing Address - Fax:585-544-1359
Practice Address - Street 1:800 CARTER STREET
Practice Address - Street 2:LIFETIME HEALTH MEDICAL GROUP
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2607
Practice Address - Country:US
Practice Address - Phone:585-338-1200
Practice Address - Fax:585-544-1359
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6368461163WC1500X
NY340186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health