Healthcare Provider Details

I. General information

NPI: 1609836550
Provider Name (Legal Business Name): BARBARA A MACEY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 RIDGE RD E
ROCHESTER NY
14622-2157
US

IV. Provider business mailing address

125 LATTIMORE RD SUITE 270
ROCHESTER NY
14620-4159
US

V. Phone/Fax

Practice location:
  • Phone: 585-266-8401
  • Fax: 585-266-2029
Mailing address:
  • Phone: 575-442-2075
  • Fax: 585-244-4298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF300986
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: