Healthcare Provider Details

I. General information

NPI: 1245554013
Provider Name (Legal Business Name): CAROL SZYMCZAK PLOTKIN M.S., R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HAGEN DR 200
ROCHESTER NY
14625-2660
US

IV. Provider business mailing address

10 HAGEN DR 200
ROCHESTER NY
14625-2660
US

V. Phone/Fax

Practice location:
  • Phone: 585-770-1045
  • Fax: 585-385-6071
Mailing address:
  • Phone: 585-770-1045
  • Fax: 585-385-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: