Healthcare Provider Details

I. General information

NPI: 1598034530
Provider Name (Legal Business Name): ROCHESTER CITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 W BROAD ST
ROCHESTER NY
14614-1103
US

IV. Provider business mailing address

131 W BROAD ST
ROCHESTER NY
14614-1103
US

V. Phone/Fax

Practice location:
  • Phone: 585-328-5272
  • Fax:
Mailing address:
  • Phone: 585-328-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number0051771-1
License Number StateNY

VIII. Authorized Official

Name: MRS. ELAINE BEAUMONT KADAR
Title or Position: OCCUPATIONAL THERAPIST/RESISTERED
Credential: BS
Phone: 585-328-5272