Healthcare Provider Details

I. General information

NPI: 1003862590
Provider Name (Legal Business Name): PELPARI CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 RIDGE RD WEST SUITE 205
ROCHESTER NY
14615-2511
US

IV. Provider business mailing address

1577 RIDGE RD WEST SUITE 205
ROCHESTER NY
14615-2511
US

V. Phone/Fax

Practice location:
  • Phone: 585-663-4620
  • Fax: 585-663-8311
Mailing address:
  • Phone: 585-663-4620
  • Fax: 585-663-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN PELS
Title or Position: OWNER
Credential:
Phone: 585-663-4620