Provider Demographics
NPI:1578665113
Name:HOLT, ANDREW D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:HOLT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 TITUS AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617
Mailing Address - Country:US
Mailing Address - Phone:585-266-0310
Mailing Address - Fax:585-266-9207
Practice Address - Street 1:485 TITUS AVE
Practice Address - Street 2:SUITE F
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617
Practice Address - Country:US
Practice Address - Phone:585-266-0310
Practice Address - Fax:585-266-9207
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143719208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics