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General NPI Number Information
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NPI Number | 1982410213
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Entity Type | Individual
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Provider Name | LEJLA PACAVAR
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Gender | Female
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 103 CANAL LANDING BLVD STE 12
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City | ROCHESTER
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State | NY
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Zip | 14626-4181
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Country | US
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Telephone | 585-227-1080
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Fax | 585-723-7709
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Provider Business Mailing Address
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Address Line | 1827 JACKSON RD
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City | PENFIELD
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State | NY
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Zip | 14526-1215
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Country | US
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Telephone | 585-298-0636
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 355215
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 355215
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License Number State | NY
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