National Provider Identifier
Irondequoit Pediatrics, PLLC
Irondequoit Pediatrics, PLLC is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Rochester, NY and a listed phone number of (585) 266-0310.
Profile Overview
- NPI
- 1164727475
- Provider Type
- Organization
- Primary Specialty
- Pediatrics Physician
- Enumeration Date
- January 18, 2011
- Last Updated
- November 16, 2018
Practice Location
- 809 East Ridge Road
- Rochester, NY 14621-1710
Phone: (585) 266-0310
Specialties
- Pediatrics Physician (208000000X)
Full Record
- NPI
- 1164727475
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Irondequoit Pediatrics, PLLC
- Mailing Street Address
- 809 East Ridge Road
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-1710
- Mailing Country
- US
- Mailing Phone
- (585) 266-0310
- Mailing Fax
- (585) 266-9207
- Practice Street Address
- 809 East Ridge Road
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-1710
- Practice Country
- US
- Practice Phone
- (585) 266-0310
- Practice Fax
- (585) 266-9207
- Enumeration Date
- January 18, 2011
- Last Updated
- November 16, 2018
- Authorized Official Last Name
- Bennett
- Authorized Official First Name
- Douglas
- Authorized Official Middle Name
- Howard
- Authorized Official Title
- MD, Owner
- Authorized Official Phone
- (585) 266-0310
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mr.
- Authorized Official Credential Text
- M.D.
- Taxonomy Group 1
- 193400000X Single Specialty Group
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatrics Physician (208000000X)