Most Relevant Information
Provider Data
| NPI Number: | 1003257809 |
| Provider Name: | MACKENZIE R. PETTINELLA PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 016626 |
Most Important Dates
| Enumeration Date: | 07/10/2013 |
| Last Updated: | 01/04/2023 |
Provider Practice Location
1555 LONG POND RD
DEPT. OF MEDICINE
ROCHESTER
NY
146264122
Practice Location Phone/Fax
| Phone: | 5857237870 |
| Fax: | 5857237871 |
Provider Mailing Location
100 KINGS HWY S
ROCHESTER
NY
146175504
Provider Mailing Phone/Fax
| Phone: | 5859220553 |
| Fax: |