Healthcare Provider Details

I. General information

NPI: 1205870854
Provider Name (Legal Business Name): PATRICIA TERNEY BISHOP AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 WESTFALL RD
ROCHESTER NY
14620-4645
US

IV. Provider business mailing address

1608 WHEATSTONE DR
FARMINGTON NY
14425-9360
US

V. Phone/Fax

Practice location:
  • Phone: 585-463-2701
  • Fax:
Mailing address:
  • Phone: 585-398-2035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001895-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: