| Doctor Name: | CARRI L ROSS |
| NPI Number: | 1124009261 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 0095771 |
| Business Practice Address: | 4104 Vestal Rd Vestal Executive Park Suite 203 Vestal, NY - 138503500 |
| Business Phone Number: | 6077979036 |
| Business Fax Number: | 6077980601 |
| Mailing Address: | 4104 Vestal Rd., Vestal Executive Park Suite 203 VESTAL |
| State: | NY |
| Postal Code: | 13850 |
| Phone Number: | 6077979036 |
| Fax Number: | 6077980601 |
| NPI Enumeration Date: | 11/07/2005 |
| NPI Last Update Date: | 04/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0095771 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |