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General NPI Number Information
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NPI Number | 1306242763
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Entity Type | Organization
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Legal Business Name | ROCHESTER INSTITUTE OF TECHNOLOGY
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 1 LOMB MEMORIAL DRIVE
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City | ROCHESTER
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State | NY
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Zip | 14623
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Country | US
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Telephone | 585-475-4065
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Fax | 585-475-4067
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Provider Business Mailing Address
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Address Line | 1 LOMB MEMORIAL DRIVE ROCHESTER INSTITUTE OF TECHNOLOGY
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City | ROCHESTER
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State | NY
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Zip | 14623
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Country | US
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Telephone | 585-475-4065
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Fax | 585-475-4067
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. CAROLINE JOAN EASTON
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Credential | PH.D.
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Telephone | 203-915-4923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 002261
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 020890-1
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License Number State | NY
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