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General NPI Number Information
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NPI Number | 1619622677
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Entity Type | Individual
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Provider Name | DR. BRANDON DUCA
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Gender | Male
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 95 CANAL LANDING BLVD
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City | ROCHESTER
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State | NY
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Zip | 14626-5111
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Country | US
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Telephone | 585-617-0581
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Fax |
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Provider Business Mailing Address
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Address Line | 84 MISTY PINE RD
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City | FAIRPORT
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State | NY
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Zip | 14450-2630
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Country | US
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Telephone | 585-478-2926
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 048455-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 048455
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License Number State | NY
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