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HENRIETTA PEDIATRICS PLLC NPI 1912576034


NPI Information

NPI: 1912576034
Provider Name: HENRIETTA PEDIATRICS, PLLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 33D2237191

Address:
1200 JEFFERSON RD STE 115
ROCHESTER, NY
ZIP 14623
Phone: (585) 601-2600
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HENRIETTA PEDIATRICS, PLLC is a pediatrics in Rochester, NY. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. HENRIETTA PEDIATRICS, PLLC NPI is 1912576034. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1200 JEFFERSON RD STE 115
ROCHESTER, NY
ZIP 14623-158
Phone: (585) 601-2600
Fax: (585) 229-6008

The provider's authorized official is Emilie Ellicott .
The authorized official title is Physician and has the following contact phone number (585) 451-7014.

The CLIA number assigned to this NPI record is 33D2237191 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2021 and was last updated on 10/22/2021.


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
1208000000XPediatricsYes

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
11801110697MEDICAIDNEW 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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