Provider Demographics
NPI:1669644696
Name:PITTSFORD DERMATOLOGY, PLLC
Entity Type:Organization
Organization Name:PITTSFORD DERMATOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAPKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-389-1960
Mailing Address - Street 1:115 SULLYS TRL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4571
Mailing Address - Country:US
Mailing Address - Phone:585-389-1960
Mailing Address - Fax:585-389-1947
Practice Address - Street 1:115 SULLYS TRL
Practice Address - Street 2:SUITE 2
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4571
Practice Address - Country:US
Practice Address - Phone:585-389-1960
Practice Address - Fax:585-389-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1544Medicare PIN
NYG67455Medicare UPIN