1467138180 NPI number — ASIA L TODD NP IN PSYCHIATRY PLLC

Table of content: (NPI 1467138180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467138180 NPI number — ASIA L TODD NP IN PSYCHIATRY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASIA L TODD NP IN PSYCHIATRY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1467138180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
82 WOODLANDS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROCKPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14420-2658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-774-1029
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200A SCOTTSVILLE RD STE 399
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14624-5709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-774-1029
Provider Business Practice Location Address Fax Number:
689-205-9899
Provider Enumeration Date:
06/27/2023

Additional Information

Authorized Official

Authorized Official Last Name:
TODD
Authorized Official First Name:
ASIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHIATRIC NURSE PRACTITIONER
Authorized Official Telephone Number:
585-774-1029

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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