Healthcare Provider Details

I. General information

NPI: 1619172327
Provider Name (Legal Business Name): ERICA PATRICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HAGEN DR SUITE 300
ROCHESTER NY
14625-2666
US

IV. Provider business mailing address

20 HAGEN DR. SUITE 300
ROCHESTER NY
14623
US

V. Phone/Fax

Practice location:
  • Phone: 585-586-7550
  • Fax: 585-586-7588
Mailing address:
  • Phone: 585-586-7550
  • Fax: 585-586-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number260784
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: