PED PHYSICAL DISABILITIES NPI 1508809872

NPI Information

NPI: 1508809872
Provider Name: PED PHYSICAL DISABILITIES
Classification: Pediatrics - 2080P0008X
Entity Type: Organization

Specialization: Neurodevelopmental Disabilities

Address:
601 ELMWOOD AVE
BOX 635
ROCHESTER, NY
ZIP 14642
Phone: (585) 275-7787
Get Directions

PED PHYSICAL DISABILITIES is a neurodevelopmental disabilities pediatrics in Rochester, NY. The provider is a pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. PED PHYSICAL DISABILITIES NPI is 1508809872. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

601 ELMWOOD AVE
BOX 635
ROCHESTER, NY
ZIP 14642-001
Phone: (585) 275-7787

The provider's authorized official is Jennifer Knebel .
The authorized official title is Billing Manager and has the following contact phone number (585) 275-7787.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2080P0008X	Pediatrics	Neurodevelopmental Disabilities	Yes
2	208800000X	Urology		X
3	207X00000X	Orthopaedic Surgery		X
4	207T00000X	Neurological Surgery		X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00512758	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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