Provider Demographics
NPI:1255018693
Name:AUDET, ANTOINE (PA-C)
Entity type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:AUDET
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1555 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4164
Mailing Address - Country:US
Mailing Address - Phone:585-723-7225
Mailing Address - Fax:585-723-7280
Practice Address - Street 1:1555 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4164
Practice Address - Country:US
Practice Address - Phone:585-723-7225
Practice Address - Fax:585-723-7280
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2024-02-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant