MEDICARE: ALICE M. TARIOT M.D., P.C.

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	2084P0804X	Child & Adolescent Psychiatry Physician	165704	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	400791	NY
3	2084P0800X	Psychiatry Physician	165704	NY

General Provider Information

NPI Number	:	1710063003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALICE M. TARIOT M.D., P.C.

Provider Business Mailing Address
First Line	:	132 ALLENS CREEK RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3310
Country	:	US
Telephone Number	:	585-241-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 ALLENS CREEK RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3310
Country	:	US
Telephone Number	:	585-241-9330
Fax Number	:	585-241-9349

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALICE M TARIOT
Credential	:	M.D.
Telephone Number	:	585-241-9330

Provider Enumeration Date	:	10/28/2006
Last Update Date	:	12/22/2007

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