Provider Demographics
NPI:1467138180
Name:ASIA L TODD NP IN PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:ASIA L TODD NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-774-1029
Mailing Address - Street 1:82 WOODLANDS
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2658
Mailing Address - Country:US
Mailing Address - Phone:585-774-1029
Mailing Address - Fax:
Practice Address - Street 1:4050 W RIDGE RD STE 127
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3528
Practice Address - Country:US
Practice Address - Phone:585-774-1029
Practice Address - Fax:689-205-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty