Healthcare Provider Details

I. General information

NPI: 1205753373
Provider Name (Legal Business Name): AZELLEE NARIAH ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 DEWEY AVE
ROCHESTER NY
14616-3741
US

IV. Provider business mailing address

170 ROXBOROUGH RD
ROCHESTER NY
14619-1418
US

V. Phone/Fax

Practice location:
  • Phone: 585-865-1550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: