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NPI Code Detail

MEDICARE: JESSE PARTRICK MSED

MEDICARE: JESSE PARTRICK MSED
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1568132876
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE PARTRICK MSED
Provider Business Mailing Address
First Line : 2000 WINTON RD S BLDG 2
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3922
Country : US
Telephone Number : 585-368-4719
Fax Number : 585-272-0704
Provider Business Practice Location Address
First Line : 2000 WINTON RD S BLDG 2
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-3922
Country : US
Telephone Number : 585-368-4719
Fax Number : 585-272-0704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2021
Last Update Date : 09/17/2021

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Directions to “ JESSE PARTRICK MSED” Practice Location

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