Provider Demographics
NPI:1538550835
Name:ROSS, ARIANA WHITNEY (PA-C)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:WHITNEY
Last Name:ROSS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13523 82ND AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1346
Mailing Address - Country:US
Mailing Address - Phone:520-465-9011
Mailing Address - Fax:
Practice Address - Street 1:1315 YORK AVE
Practice Address - Street 2:MEZZANINE LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5304
Practice Address - Country:US
Practice Address - Phone:212-746-5548
Practice Address - Fax:212-746-8144
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018417363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical