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General NPI Number Information
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NPI Number | 1669424925
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Entity Type | Individual
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Provider Name | STEPHEN L PELTON MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 220 LINDEN OAKS STE 300
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City | ROCHESTER
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State | NY
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Zip | 14625-2839
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Country | US
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Telephone | 585-383-4420
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Fax | 585-383-4515
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Provider Business Mailing Address
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Address Line | 220 LINDEN OAKS STE 300
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City | ROCHESTER
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State | NY
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Zip | 14625-2839
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Country | US
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Telephone | 585-383-4420
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Fax | 585-383-4515
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 115901
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License Number State | NY
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