Healthcare Provider Details

I. General information

NPI: 1700475035
Provider Name (Legal Business Name): ROC PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 ATLANTIC AVE LOWR LEVEL
ROCHESTER NY
14609-7614
US

IV. Provider business mailing address

1225 ATLANTIC AVE
ROCHESTER NY
14609-7614
US

V. Phone/Fax

Practice location:
  • Phone: 585-484-0005
  • Fax: 585-495-2353
Mailing address:
  • Phone: 585-484-0005
  • Fax: 585-495-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL STEWART
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT, SCS
Phone: 585-484-0005