Healthcare Provider Details

I. General information

NPI: 1417998469
Provider Name (Legal Business Name): KEITH J. DELMONTE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 638
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

59 VALLEY BROOK DR
FAIRPORT NY
14450-9345
US

V. Phone/Fax

Practice location:
  • Phone: 585-273-1313
  • Fax:
Mailing address:
  • Phone: 585-223-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040471
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number040471
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: