Healthcare Provider Details

I. General information

NPI: 1033774005
Provider Name (Legal Business Name): LAUREN KAY PALICKI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E RIVER RD
ROCHESTER NY
14623-1212
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX 635
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number315022
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: