Healthcare Provider Details

I. General information

NPI: 1003757550
Provider Name (Legal Business Name): ANDREA ELIZABETH BARRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SAWGRASS DR STE 120
ROCHESTER NY
14620-4654
US

IV. Provider business mailing address

160 SAWGRASS DR STE 120
ROCHESTER NY
14620-4654
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number717744
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF359916-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: