MEDICARE: ROCHESTER PSYCHIATRIC ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	213630	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821027426	OTHER	NY	NPI

General Provider Information

NPI Number	:	1013337039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCHESTER PSYCHIATRIC ASSOCIATES

Provider Business Mailing Address
First Line	:	40 OFFICE PKWY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1738
Country	:	US
Telephone Number	:	585-218-2022
Fax Number	:	646-706-0095

Provider Business Practice Location Address
First Line	:	40 OFFICE PKWY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1738
Country	:	US
Telephone Number	:	585-218-2022
Fax Number	:	646-706-0095

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT MARK REDONDO
Credential	:	M.D.
Telephone Number	:	585-218-2022

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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Directions to “ROCHESTER PSYCHIATRIC ASSOCIATES ” Practice Location

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