Healthcare Provider Details

I. General information

NPI: 1508462896
Provider Name (Legal Business Name): NUTRITION CARE OF ROCHESTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 12/10/2020
Certification Date: 12/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3380 MONROE AVE STE 213
ROCHESTER NY
14618-4726
US

IV. Provider business mailing address

150 WIMBLEDON RD
ROCHESTER NY
14617-4229
US

V. Phone/Fax

Practice location:
  • Phone: 585-563-9000
  • Fax: 585-301-4895
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. AMANDA RONZO
Title or Position: OWNER
Credential: MS. RDN. CLC. CDN
Phone: 585-563-9000