Provider Demographics
NPI:1568132876
Name:PARTRICK, JESSE (MSED)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:PARTRICK
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WINTON RD S BLDG 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3922
Mailing Address - Country:US
Mailing Address - Phone:585-368-4719
Mailing Address - Fax:585-272-0704
Practice Address - Street 1:2000 WINTON RD S BLDG 2
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3922
Practice Address - Country:US
Practice Address - Phone:585-368-4719
Practice Address - Fax:585-272-0704
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)