Basic Information
| Provider Information | |||||||||
| NPI: | 1760920318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROMWELL | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | KAIER | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 SCIENCE PARKWAY | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146428409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852753563 | ||||||||
| FaxNumber: | 5852762292 | ||||||||
| Practice Location | |||||||||
| Address1: | 2180 S CLINTON AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146182665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853408949 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 03/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 022905 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.