Provider Demographics
NPI:1821838293
Name:ROCHESTER PSYCHOLOGICAL EVALUATION
Entity type:Organization
Organization Name:ROCHESTER PSYCHOLOGICAL EVALUATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTWOUT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:585-586-1600
Mailing Address - Street 1:100 LINDEN OAKS STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2831
Mailing Address - Country:US
Mailing Address - Phone:585-586-1600
Mailing Address - Fax:
Practice Address - Street 1:100 LINDEN OAKS STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2831
Practice Address - Country:US
Practice Address - Phone:585-586-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty