Provider Demographics
NPI:1588207187
Name:TOTH, JESSE
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:TOTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6836 GILLIS RD
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9709
Mailing Address - Country:US
Mailing Address - Phone:585-953-0971
Mailing Address - Fax:
Practice Address - Street 1:6836 GILLIS RD
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9709
Practice Address - Country:US
Practice Address - Phone:585-953-0971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer