Provider Demographics
NPI:1245206606
Name:PACIORKOWSKI, ALEXANDER R (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:R
Last Name:PACIORKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 278984
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-275-1200
Mailing Address - Fax:585-756-5189
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG C, SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-341-7500
Practice Address - Fax:585-341-7510
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2007013167208000000X, 2084N0402X
NY266133363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
I45585Medicare UPIN