Healthcare Provider Details

I. General information

NPI: 1932387131
Provider Name (Legal Business Name): ROCHESTER HEARING AND SPEECH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ELMWOOD AVE STE 400
ROCHESTER NY
14620-3042
US

IV. Provider business mailing address

104 TREMONT CIR
ROCHESTER NY
14608-2461
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-0680
  • Fax:
Mailing address:
  • Phone: 585-355-6654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number1928062
License Number StateNY

VIII. Authorized Official

Name: MELISSA MARY BACHER
Title or Position: SPECIAL EDUCATION ITINERANT TEACHER
Credential: M.S
Phone: 585-355-6654