Healthcare Provider Details

I. General information

NPI: 1942115753
Provider Name (Legal Business Name): KIM SADWICK, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 W RIDGE RD STE 304
ROCHESTER NY
14626-3037
US

IV. Provider business mailing address

2450 W RIDGE RD STE 304
ROCHESTER NY
14626-3037
US

V. Phone/Fax

Practice location:
  • Phone: 585-331-9604
  • Fax: 872-241-0392
Mailing address:
  • Phone: 585-331-9604
  • Fax: 872-241-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIM SADWICK
Title or Position: CEO
Credential: PMHNP-BC
Phone: 585-331-9604