Basic Information
| Provider Information | |||||||||
| NPI: | 1245206606 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PACIORKOWSKI | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | BOX 278984 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852751200 | ||||||||
| FaxNumber: | 5857565189 | ||||||||
| Practice Location | |||||||||
| Address1: | 919 WESTFALL RD | ||||||||
| Address2: | BLDG C, SUITE 220 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853417500 | ||||||||
| FaxNumber: | 5853417510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2006 | ||||||||
| LastUpdateDate: | 08/02/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0402X | 2007013167 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | 208000000X | 2007013167 | MO | N | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.