OrganizationActive
Pediatric Immun-Nephr-Rheumology
NPI 1205940152 · Pediatric Nephrology Physician · Rochester, NY
Provider details
- NPI number
- 1205940152
- Entity type
- Organization
- Primary specialty
- Pediatric Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jill Hetterich, Authorized Official(585) 756-4008
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pediatric Allergy/Immunology Physician2080P0201X
Allopathic & Osteopathic Physicians
- Pediatric Rheumatology Physician2080P0216X
Allopathic & Osteopathic Physicians
Practice location
601 Elmwood Ave
Box 635
Rochester, NY 14642-0001
Phone: (585) 275-7787
Approximate (ZIP-level) locationGet directions
Mailing address
601 Elmwood Ave
Rochester, NY 14642-0001
Registry dates
- Enumerated
- 2006-08-18
- Last updated
- 2025-04-28
- Certified
- 2025-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.