Provider Demographics
NPI:1538631502
Name:NILSSON THERAPEUTICS PC
Entity type:Organization
Organization Name:NILSSON THERAPEUTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUBREE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MONU
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:585-687-8887
Mailing Address - Street 1:3896 DEWEY AVE STE 195
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-2527
Mailing Address - Country:US
Mailing Address - Phone:585-663-7140
Mailing Address - Fax:
Practice Address - Street 1:309 EXCHANGE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-2708
Practice Address - Country:US
Practice Address - Phone:585-687-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty