Provider Demographics
NPI:1871013516
Name:PEBBLE KRANZ, MD PLLC
Entity Type:Organization
Organization Name:PEBBLE KRANZ, MD PLLC
Other - Org Name:ROCHESTER CENTER FOR SEXUAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PEBBLE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-355-5708
Mailing Address - Street 1:625 PANORAMA TRL STE 2220
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2431
Mailing Address - Country:US
Mailing Address - Phone:585-355-5708
Mailing Address - Fax:
Practice Address - Street 1:625 PANORAMA TRL STE 2220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2431
Practice Address - Country:US
Practice Address - Phone:585-865-3584
Practice Address - Fax:844-765-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257853207Q00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty