NPI Code Detail JSON Logo

1063094688 NPI number — JESSICA KURZDORFER NURSE PRACTITIONER IN PSYCHIATRY PC

NPI Number: 1063094688
Health Care Provider/Practitioner: JESSICA KURZDORFER NURSE PRACTITIONER IN PSYCHIATRY PC

Information about “1063094688” NPI (JESSICA KURZDORFER NURSE PRACTITIONER IN PSYCHIATRY PC) exists in 1063094688 in HTML format HTML  |  1063094688 in plain Text format TXT  |  1063094688 in PDF (Portable Document Format) PDF  |  1063094688 in an XML format XML  formats.

NPI Number : 1063094688 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063094688",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JESSICA KURZDORFER NURSE PRACTITIONER IN PSYCHIATRY PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "59 ROWLEY ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCHESTER",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14607-2630",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "585-360-7554",
    "MailingAddressFaxNumber": "949-577-4708",
    "FirstLinePracticeLocationAddress": "95 ALLENS CREEK RD STE 330",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROCHESTER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14618-3246",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-360-7554",
    "PracticeLocationAddressFaxNumber": "949-577-4708",
    "EnumerationDate": "04/23/2021",
    "LastUpdateDate": "12/12/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KURZDORFER",
    "AuthorizedOfficialFirstName": "SEAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "NURSE PRACTITIONER/PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PMHNP",
    "AuthorizedOfficialTelephoneNumber": "585-360-7554",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QC1500X",
          "TaxonomyName": "Community Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.