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NPI Code Detail

MEDICARE: KRISTEN NOEL ROTUNDO CONJERTI LCSW

MEDICARE: KRISTEN NOEL ROTUNDO CONJERTI LCSW
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
11041C0700XClinical Social Worker077649-1NY

General Provider Information

NPI Number : 1780838748
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN NOEL ROTUNDO CONJERTI LCSW
Provider Business Mailing Address
First Line : 224 ALEXANDER ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-4000
Country : US
Telephone Number : 585-922-7259
Fax Number :
Provider Business Practice Location Address
First Line : 500 WEBSTER AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14609-4732
Country : US
Telephone Number : 585-482-9290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2008
Last Update Date : 04/11/2014

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