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Specialty details in registry · Rochester, NY

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At a glance

111 Northlane Dr, Rochester, NY 14621-2025

NPPES record updated Nov 21, 2019. Public records can lag behind changes at a practice.

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Practice location

111 Northlane Dr
Rochester, NY 14621-2025

Professional details: NPI, taxonomy & registry record

NPI1619513959

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 343900000X
Enumeration date: Nov 21, 2019
Record updated: Nov 21, 2019

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

343900000X · Primary

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

Practice location

111 Northlane Dr
Rochester, NY 14621-2025

Phone: (585) 867-2851

Mailing address

111 NORTHLANE DR

ROCHESTER, NY 146212025

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

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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