National Provider Identifier

Mary M Reyngoudt

Mary M Reyngoudt is listed in the NPPES registry with a primary specialty of Specialist in Fairport, NY and a listed phone number of (585) 377-2230.

NPI 1215588322Fairport, NYSpecialist

Profile Overview

NPI
1215588322
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
September 20, 2019
Last Updated
September 20, 2019

Practice Location

  • 149 N Main St
  • Fairport, NY 14450-1434

Phone: (585) 377-2230

Mailing Address

  • 71 Gilman RD
  • Churchville, NY 14428-9325

Specialties

  • Specialist (174400000X)
Full Record
NPI
1215588322
Entity Type
Individual
Last Name
Reyngoudt
First Name
Mary
Middle Name
M
Mailing Street Address
71 Gilman RD
Mailing City
Churchville
Mailing State
NY
Mailing ZIP Code
14428-9325
Mailing Country
US
Mailing Phone
(585) 530-0515
Practice Street Address
149 N Main St
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-1434
Practice Country
US
Practice Phone
(585) 377-2230
Practice Fax
(585) 377-2243
Enumeration Date
September 20, 2019
Last Updated
September 20, 2019
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)