Healthcare Provider Details

I. General information

NPI: 1952684748
Provider Name (Legal Business Name): VALERIE LYNN PACHUTA ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 MILLENNIUM DR
GENESEO NY
14454-1192
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-424-6770
  • Fax: 585-424-6776
Mailing address:
  • Phone: 585-424-6770
  • Fax: 585-424-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number305683
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: