Provider Demographics
NPI:1568100279
Name:ROCHESTER NEUROPSYCHOLOGY SERVICES PLLC
Entity Type:Organization
Organization Name:ROCHESTER NEUROPSYCHOLOGY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIMBY TREMAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-271-7517
Mailing Address - Street 1:4115 26TH ST NW STE 104
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-8339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4115 26TH ST NW STE 104
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-8339
Practice Address - Country:US
Practice Address - Phone:507-271-7517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center