Healthcare Provider Details
I. General information
NPI: 1285205286
Provider Name (Legal Business Name): IRONDEQUOIT CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2021
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2164 HUDSON AVE
ROCHESTER NY
14617-3960
US
IV. Provider business mailing address
2164 HUDSON AVE
ROCHESTER NY
14617-3960
US
V. Phone/Fax
- Phone: 585-467-7070
- Fax: 585-467-7702
- Phone: 585-467-7070
- Fax: 585-467-7702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAWRENCE
CHARLES
PESHKIN
Title or Position: OWNER
Credential: DC
Phone: 585-467-7070