Healthcare Provider Details

I. General information

NPI: 1134030034
Provider Name (Legal Business Name): FNU PAYAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 PORTLAND AVE
ROCHESTER NY
14621-3095
US

IV. Provider business mailing address

35 PORTLAND PKWY APT 1
ROCHESTER NY
14621-2828
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-0390
  • Fax:
Mailing address:
  • Phone: 585-451-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: