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General NPI Number Information
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NPI Number | 1861190415
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Entity Type | Organization
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Legal Business Name | NEXUS NEUROPSYCHIATRY PLLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 1655 ELMWOOD AVE STE 220
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City | ROCHESTER
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State | NY
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Zip | 14620-3426
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Country | US
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Telephone | 814-969-3980
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Fax | 585-460-9835
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Provider Business Mailing Address
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Address Line | PO BOX 18102
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City | ROCHESTER
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State | NY
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Zip | 14618-0102
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Country | US
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Telephone | 814-969-3980
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Fax | 585-460-9835
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | SHANE STEGEN
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Credential | DO
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Telephone | 814-969-3980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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