Healthcare Provider Details

I. General information

NPI: 1710063003
Provider Name (Legal Business Name): ALICE M. TARIOT M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 12/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 ALLENS CREEK RD
ROCHESTER NY
14618-3310
US

IV. Provider business mailing address

132 ALLENS CREEK RD
ROCHESTER NY
14618-3310
US

V. Phone/Fax

Practice location:
  • Phone: 585-241-9330
  • Fax: 585-241-9349
Mailing address:
  • Phone: 585-241-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number165704
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number400791
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number165704
License Number StateNY

VIII. Authorized Official

Name: DR. ALICE M TARIOT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 585-241-9330