MARC GAUDETTE PH D NPI 1558398321

NPI Information

NPI: 1558398321
Provider Name: MARC GAUDETTE, PH D
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 2655 RIDGEWAY AVE
SUITE 420
ROCHESTER, NY
ZIP 14626
Phone: (585) 723-7972

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NPI Details

Marc Gaudette, PH D is a clinical neuropsychologist in Rochester, NY. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Marc Gaudette, PH D NPI is 1558398321. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2655 RIDGEWAY AVE
SUITE 420
ROCHESTER, NY
ZIP 14626-285
Phone: (585) 723-7972
Fax: (585) 368-3119

The NPI 1558398321 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 6/27/2006 and was last updated on 3/28/2015.

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	License Number	License State	Primary
1	103T00000X	Psychologist		011956	NEW YORK	No
2	103G00000X	Clinical Neuropsychologist		011956	NEW YORK	Yes

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
1	02307028	MEDICAID	NEW YORK
2	BB6552	MEDICARE PIN	NEW YORK
3	RA0152 - GRP:BA0017	MEDICARE PIN	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: 11/21/2025

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