National Provider Identifier

Jaquanda N Peterkin

Jaquanda N Peterkin is listed in the NPPES registry with a primary specialty of Phlebology Physician in Rochester, NY and a listed phone number of (585) 362-1905.

NPI 1497633184Rochester, NYPhlebology Physician

Profile Overview

NPI
1497633184
Provider Type
Individual
Primary Specialty
Phlebology Physician
Enumeration Date
August 22, 2025
Last Updated
August 22, 2025

Practice Location

  • 165 Field St
  • Rochester, NY 14620-1943

Phone: (585) 362-1905

Specialties

  • Phlebology Physician (202K00000X)
Full Record
NPI
1497633184
Entity Type
Individual
Last Name
Peterkin
First Name
Jaquanda
Middle Name
N
Mailing Street Address
165 Field St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14620-1943
Mailing Country
US
Practice Street Address
165 Field St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14620-1943
Practice Country
US
Practice Phone
(585) 362-1905
Enumeration Date
August 22, 2025
Last Updated
August 22, 2025
Sex
X
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
August 22, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Phlebology Physician (202K00000X)