Provider Demographics
NPI:1275169419
Name:HULETT, PATRICK CHARLES
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:CHARLES
Last Name:HULETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MARKETPLACE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-6000
Mailing Address - Country:US
Mailing Address - Phone:585-272-1344
Mailing Address - Fax:
Practice Address - Street 1:100 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-6000
Practice Address - Country:US
Practice Address - Phone:585-272-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000053775237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist