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General NPI Number Information
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NPI Number | 1538782826
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Entity Type | Individual
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Provider Name | SEAN KURZDORFER PMHNP
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Gender | Male
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 95 ALLENS CREEK RD
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City | ROCHESTER
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State | NY
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Zip | 14618-3250
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Country | US
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Telephone | 585-360-7554
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Fax | 949-577-4708
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Provider Business Mailing Address
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Address Line | 95 ALLENS CREEK RD STE 330
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City | ROCHESTER
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State | NY
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Zip | 14618-3246
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Country | US
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Telephone | 585-360-7554
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Fax | 949-577-4708
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 70145
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10012124
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R268663
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402976
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License Number State | NY
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