Provider Demographics
NPI:1952651317
Name:PEDULLA, SARA MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:PEDULLA
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Gender:F
Credentials:NP
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Mailing Address - Street 1:BOX 679-B
Mailing Address - Street 2:601 ELMWOOD AVE.
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-341-6780
Mailing Address - Fax:585-341-8489
Practice Address - Street 1:1000 SOUTH AVE
Practice Address - Street 2:CARDIOLOGY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2733
Practice Address - Country:US
Practice Address - Phone:585-341-6780
Practice Address - Fax:585-341-8489
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2023-07-07
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Provider Licenses
StateLicense IDTaxonomies
NYF430587-1363LA2100X
NY430587363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical