Healthcare Provider Details
I. General information
NPI: 1245268275
Provider Name (Legal Business Name): BARRINGTON PARK DERMATOLOGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 LINDEN OAKS STE 300
ROCHESTER NY
14625-2839
US
IV. Provider business mailing address
220 LINDEN OAKS STE 300
ROCHESTER NY
14625-2839
US
V. Phone/Fax
- Phone: 585-383-4420
- Fax: 585-383-4515
- Phone: 585-383-4420
- Fax: 585-383-4515
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PAMELA
A
LEVE
Title or Position: PRESIDENT
Credential: MD
Phone: 585-383-4420