MEDICARE: MR. JON GOOTNICK PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	002056	NY

General Provider Information

NPI Number	:	1578506515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JON GOOTNICK PA

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-922-0527
Fax Number	:

Provider Business Practice Location Address
First Line	:	2685 E HENRIETTA RD
Second Line	:
City	:	HENRIETTA
State	:	NY
Zip	:	14467-9370
Country	:	US
Telephone Number	:	585-444-0058
Fax Number	:	585-444-0108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	12/24/2022

Similar Medicare Providers

1033068523 — MEGAN NELL SLYMON NP
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax: 585-444-0108

1588791156 — WALGREEN CO
Practice Location Address:

2665 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-359-3250
Practice Fax: 585-359-3267

1063655298 — MARC ALLEN HERBERT R.N.
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax: 585-444-0108

1932423282 — MR. GARY WAYNE WILLISON RPH
Practice Location Address:

2665 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-359-3250
Practice Fax:

1558600841 — MS. LATANYA TENZA WHITE FNP
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax:

1902254667 — STEPHANIE LYNNE WIERZBA
Practice Location Address:

2685 E HENRIETTA RD
HENRIETTA, NY
14467-9370

Practice Phone: 585-444-0058
Practice Fax:

Directions to “ MR. JON GOOTNICK PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.