Most Relevant Information
Provider Data
| NPI Number: | 1003499161 |
| Provider Name: | KAITLYN ISOLDE ROSS PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/05/2021 |
| Last Updated: | 05/05/2021 |
Provider Practice Location
1 CAMPUS RD
STATEN ISLAND
NY
103014479
Practice Location Phone/Fax
| Phone: | 7184204151 |
| Fax: |
Provider Mailing Location
54 COLTON AVE
SAYVILLE
NY
117823106
Provider Mailing Phone/Fax
| Phone: | 6316242188 |
| Fax: |