National Provider Identifier

Rochester Lifestyle Medicine PLLC

Rochester Lifestyle Medicine PLLC is listed in the NPPES registry with a primary specialty of Public Health & General Preventive Medicine Physician in Rochester, NY and a listed phone number of (585) 484-1254.

NPI 1013380823Rochester, NYPublic Health & General Preventive Medicine Physician

Profile Overview

NPI
1013380823
Provider Type
Organization
Primary Specialty
Public Health & General Preventive Medicine Physician
Enumeration Date
November 03, 2015
Last Updated
March 08, 2016

Practice Location

  • 1441 East Ave
  • Suite 108
  • Rochester, NY 14610-1665

Phone: (585) 484-1254

Mailing Address

  • PO Box 22844
  • Rochester, NY 14692-2844

Specialties

  • Public Health & General Preventive Medicine Physician (2083P0901X)
Full Record
NPI
1013380823
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Rochester Lifestyle Medicine PLLC
Mailing Street Address
PO Box 22844
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14692-2844
Mailing Country
US
Practice Street Address
1441 East Ave
Practice Address Line 2
Suite 108
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14610-1665
Practice Country
US
Practice Phone
(585) 484-1254
Enumeration Date
November 03, 2015
Last Updated
March 08, 2016
Authorized Official Last Name
Barnett
Authorized Official First Name
Ted
Authorized Official Middle Name
D
Authorized Official Title
Member
Authorized Official Phone
(585) 533-1368
Organization Subpart
No
Authorized Official Name Prefix Text
Dr.
Authorized Official Credential Text
M.D.
Taxonomy Group 1
193200000X Multi-Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Public Health & General Preventive Medicine Physician (2083P0901X)