Provider Demographics
NPI:1871696401
Name:RODGERS, CHRISTINE A (RPA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:RODGERS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-0505
Mailing Address - Country:US
Mailing Address - Phone:585-594-5995
Mailing Address - Fax:585-594-5425
Practice Address - Street 1:4201 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-1256
Practice Address - Country:US
Practice Address - Phone:585-594-5995
Practice Address - Fax:585-594-5425
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005478363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
00570414001OtherCOMMUNITY BL ADV
040426004288OtherFIDELIS
00570414001OtherCOMMUNITY BLUE
00570414001OtherFAMILY HEALTH PLUS
7387280OtherAETNA
9512290OtherIHA CUSTOM COVERAGE
00570414001OtherHEALTHY NY
7387280OtherAETNA HMO
9512290OtherIHA ENCOMPASS 65
00570414001OtherBCBCS OF WNY
7387280OtherAETNA PPO POS
9512290OtherIHA
00570414001OtherHMO 100
00570414001OtherCOMMUNITY CARE
00570414001OtherASO PPO
00570414001OtherCHILD HEALTH PLUS
00570414001OtherSENIOR BLUE
7387280OtherAETNA
7387280OtherAETNA HMO
9512290OtherIHA