Provider Demographics
NPI:1649068263
Name:PURCELL, KAYLA SOPHIE (PA)
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:SOPHIE
Last Name:PURCELL
Suffix:
Gender:
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE BLDG 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3095
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTLAND AVE BLDG 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3095
Practice Address - Country:US
Practice Address - Phone:585-922-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical