Provider Demographics
NPI:1053323097
Name:REID, PATRICK J (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:REID
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2655 RIDGEWAY AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4296
Mailing Address - Country:US
Mailing Address - Phone:585-368-6545
Mailing Address - Fax:585-368-6546
Practice Address - Street 1:2655 RIDGEWAY AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-368-6545
Practice Address - Fax:585-368-6546
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2023-01-12
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Provider Licenses
StateLicense IDTaxonomies
NY242664207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400157412/GRPBA0017Medicare PIN
NYJ400157413/GRP70008AMedicare PIN