Healthcare Provider Details

I. General information

NPI: 1083014070
Provider Name (Legal Business Name): M ELIZABETH ROWE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 SAINT PAUL ST
ROCHESTER NY
14621-3162
US

IV. Provider business mailing address

3140 MAPLE AVE
WALWORTH NY
14568-9554
US

V. Phone/Fax

Practice location:
  • Phone: 585-546-7220
  • Fax:
Mailing address:
  • Phone: 585-746-2348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402285
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: