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Specialty details in registry · Utica, NY

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At a glance

1607 Genesee St, Utica, NY 13501-4731

NPPES record updated Mar 23, 2026. Public records can lag behind changes at a practice.

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Practice location

1607 Genesee St
Utica, NY 13501-4731

Professional details: NPI, taxonomy & registry record

NPI1124995592

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 261QA0600X
Enumeration date: Oct 21, 2025
Record updated: Mar 23, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

261QA0600X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1607 Genesee St
Utica, NY 13501-4731

Phone: (315) 797-4642
Fax: (315) 797-4747

Mailing address

131 GENESEE ST

UTICA, NY 135012105

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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