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General NPI Number Information
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NPI Number | 1821378365
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Entity Type | Organization
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Legal Business Name | PSYCHIATRY AND ALZHEIMER'S CARE OF ROCHESTER, PLLC
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Dates
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Enumeration Date | 08/27/2011
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 1200 JEFFERSON RD SUITE # 310
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City | ROCHESTER
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State | NY
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Zip | 14623-3158
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Country | US
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Telephone | 585-482-2273
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Fax | 585-482-2275
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Provider Business Mailing Address
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Address Line | 1200 JEFFERSON RD SUITE # 310
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City | ROCHESTER
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State | NY
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Zip | 14623-3158
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Country | US
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Telephone | 585-482-2273
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Fax | 585-482-2275
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. M. SALEEM ISMAIL
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Credential | MD
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Telephone | 585-482-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 218078
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License Number State | NY
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