Provider Demographics
NPI:1265447007
Name:BRIGGS, KATY F (PA)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:F
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PA
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:585-442-4141
Mailing Address - Fax:585-442-6259
Practice Address - Street 1:10 HAGEN DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2659
Practice Address - Country:US
Practice Address - Phone:585-442-4141
Practice Address - Fax:585-442-6259
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010639363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000928489001OtherCOMMUNITYBLUE
NY000928489001OtherHEALTHNOWNY
NY171787FLOtherPREFEREDCARE
NY02709575Medicaid
Q54055Medicare UPIN
NY171787FLOtherPREFEREDCARE