MEDICARE: KELLY MACLAREN P. T.

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	225100000X	Physical Therapist	026540	NY

General Provider Information

NPI Number	:	1134378680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY MACLAREN P. T.

Provider Business Mailing Address
First Line	:	220 LINDEN OAKS STE 100
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2839
Country	:	US
Telephone Number	:	585-264-9440
Fax Number	:	585-264-1489

Provider Business Practice Location Address
First Line	:	220 LINDEN OAKS STE 100
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2839
Country	:	US
Telephone Number	:	585-264-9440
Fax Number	:	585-264-1489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	03/16/2026

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