| Jessica Frazo, PNP | |
|
2 Rubin Dr, Rushville, NY 14544-9681 | |
| (585) 554-4400 | |
| Not Available |
| Full Name | Jessica Frazo |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 2 Rubin Dr, Rushville, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275695983 | NPI | - | NPPES |
| 02073605 | Medicaid | NY | |
| P109381105 | Other | NY | BLUE CROSS |
| 109567DL | Other | NY | PREFERRED CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | F3326901 (New York) | Primary |
| Entity Name | Mosaic Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528428208 PECOS PAC ID: 4385826585 Enrollment ID: O20110309000547 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Frazo, PNP 1 S Washington St Ste 300, Rochester, NY 14614-1134 Ph: (585) 325-2280 | Jessica Frazo, PNP 2 Rubin Dr, Rushville, NY 14544-9681 Ph: (585) 554-4400 |
Dr. Sarah R Russell, DNP, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2 Rubin Dr, Rushville, NY 14544 Phone: 585-554-4400 | |
Shannon Cotter, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2 Rubin Dr, Rushville, NY 14544 Phone: 585-554-4400 Fax: 844-683-9216 | |
Kelly Elisha R Bowen, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2 Rubin Dr, Rushville, NY 14544 Phone: 585-554-4400 Fax: 844-683-9216 |