Healthcare Provider Details

I. General information

NPI: 1033759162
Provider Name (Legal Business Name): JESSICA MARY REHO RN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 MONROE AVE
ROCHESTER NY
14607-3632
US

IV. Provider business mailing address

784 HINCHEY RD
ROCHESTER NY
14624-2738
US

V. Phone/Fax

Practice location:
  • Phone: 585-545-7200
  • Fax: 585-244-6456
Mailing address:
  • Phone: 585-613-5475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF409259-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: