Healthcare Provider Details

I. General information

NPI: 1780948513
Provider Name (Legal Business Name): LINDSAY JEAN RYKOJC MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 UNION ST
BATAVIA NY
14020-1327
US

IV. Provider business mailing address

309 PRINCETON RD
WEBSTER NY
14580-1436
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-4404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1266197
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: