Provider Demographics
NPI:1366797557
Name:BISHOP, DEBORAH ANN (R PA-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:R PA-C
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICIAN ASSISTANT
Mailing Address - Street 1:4250 FEDERAL DR
Mailing Address - Street 2:IMMIGRATION HEALTH SERVICES- BFDF
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1094
Mailing Address - Country:US
Mailing Address - Phone:585-344-5167
Mailing Address - Fax:585-345-1896
Practice Address - Street 1:4250 FEDERAL DR
Practice Address - Street 2:IMMIGRATION HEALTH SERVICES- BFDF
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1094
Practice Address - Country:US
Practice Address - Phone:585-344-5167
Practice Address - Fax:585-345-1896
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009997-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant