Healthcare Provider Details

I. General information

NPI: 1225989783
Provider Name (Legal Business Name): TRISHA LANDER FPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 N GOODMAN ST STE D103
ROCHESTER NY
14607-1173
US

IV. Provider business mailing address

274 N GOODMAN ST STE D103
ROCHESTER NY
14607-1173
US

V. Phone/Fax

Practice location:
  • Phone: 585-514-0626
  • Fax: 585-442-7615
Mailing address:
  • Phone: 585-514-0626
  • Fax: 585-325-3188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: