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PEDIATRIC G I NUTRITION NPI 1710918305


NPI Information

NPI: 1710918305
Provider Name: PEDIATRIC G I NUTRITION
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
601 ELMWOOD AVE
BOX 635
ROCHESTER, NY
ZIP 14642
Phone: (585) 275-7787
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PEDIATRIC G I NUTRITION is a pediatric gastroenterology pediatrics in Rochester, NY. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. PEDIATRIC G I NUTRITION NPI is 1710918305. The provider is registered as an organization entity type and is a single 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 Jill M Hetterich .
The authorized official title is Senior Director Of Finance Urmfg and has the following contact phone number (585) 756-4003.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 3/9/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0206XPediatricsPediatric GastroenterologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100485878MEDICAIDNEW 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

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