Provider Demographics
NPI:1295223352
Name:JANISZEWSKI, ROWAN (LMT)
Entity Type:Individual
Prefix:
First Name:ROWAN
Middle Name:
Last Name:JANISZEWSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:JANIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1174 MOUNT HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2911
Mailing Address - Country:US
Mailing Address - Phone:585-445-8584
Mailing Address - Fax:585-445-8605
Practice Address - Street 1:1577 W RIDGE RD STE 208
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-2511
Practice Address - Country:US
Practice Address - Phone:585-770-8361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030461-01225700000X
NY030461-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist