Healthcare Provider Details

I. General information

NPI: 1073614533
Provider Name (Legal Business Name): HUTHER DOYLE MEMORIAL INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 EAST AVE
ROCHESTER NY
14604-2638
US

IV. Provider business mailing address

360 EAST AVE
ROCHESTER NY
14604-2638
US

V. Phone/Fax

Practice location:
  • Phone: 585-325-5100
  • Fax:
Mailing address:
  • Phone: 585-325-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number180410827
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLY A REED
Title or Position: PRESIDENT/CEO
Credential:
Phone: 585-325-5100