{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "PSYCHIATRY AND ALZHEIMER'S CARE OF ROCHESTER, PLLC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "1200 JEFFERSON RD",
"SecondLineMailingAddress": "SUITE # 310",
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14623-3158",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-482-2273",
"MailingAddressFaxNumber": "585-482-2275",
"FirstLinePracticeLocationAddress": "1200 JEFFERSON RD",
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"PracticeLocationAddressCityName": "ROCHESTER",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "585-482-2273",
"PracticeLocationAddressFaxNumber": "585-482-2275",
"EnumerationDate": "08/27/2011",
"LastUpdateDate": "08/06/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ISMAIL",
"AuthorizedOfficialFirstName": "M. SALEEM",
"AuthorizedOfficialMiddleName": null,
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": "218078",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}