Healthcare Provider Details

I. General information

NPI: 1851341101
Provider Name (Legal Business Name): JOHN G ADDINO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 PORTLAND AVE
ROCHESTER NY
14621-2728
US

IV. Provider business mailing address

1255 PORTLAND AVE
ROCHESTER NY
14621-2728
US

V. Phone/Fax

Practice location:
  • Phone: 585-342-8700
  • Fax: 585-342-4159
Mailing address:
  • Phone: 585-342-8700
  • Fax: 585-342-4159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN002215-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: