Provider Demographics
NPI:1821378365
Name:PSYCHIATRY AND ALZHEIMER'S CARE OF ROCHESTER, PLLC
Entity Type:Organization
Organization Name:PSYCHIATRY AND ALZHEIMER'S CARE OF ROCHESTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:M. SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-482-2273
Mailing Address - Street 1:1200 JEFFERSON RD
Mailing Address - Street 2:SUITE # 310
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-3158
Mailing Address - Country:US
Mailing Address - Phone:585-482-2273
Mailing Address - Fax:585-482-2275
Practice Address - Street 1:1200 JEFFERSON RD
Practice Address - Street 2:SUITE # 310
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-3158
Practice Address - Country:US
Practice Address - Phone:585-482-2273
Practice Address - Fax:585-482-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-27
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218078261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health