Healthcare Provider Details

I. General information

NPI: 1790573764
Provider Name (Legal Business Name): KATHERINE DEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

18 SUMMIT OAKS
PITTSFORD NY
14534-3261
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2100
  • Fax:
Mailing address:
  • Phone: 585-478-2482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number700851-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF312310-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: