DR. STEPHEN TYLER DIVITO (NPI# 1972562429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972562429 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN TYLER DIVITO |
| Credential | D.C. |
| Practice Address |
572 Titus Ave Suite C Rochester NY 14617-3519 |
| Practice Telephone | 5855444077 |
| Practice Fax Number | 5855444070 |
| Mailing Telephone | 5855444077 |
| Mailing Fax Number | 5855444070 |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2008-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | X009211 | NY | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | TAX ID NO | 16-1562329 | 01 |
| Street Address |
572 TITUS AVE SUITE C |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14617-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841620028 | Jeanine Marie Connor | Counselor | 572 Titus Ave, Rochester, NY 14617-3519 | 2013-11-25 |
| 1033466388 | Judith Lundquist Lcsw Pllc | Social Worker | 572 Titus Ave, Ste B, Rochester, NY 14617-3519 | 2012-08-06 |
| 1588785182 | Judith A. Lundquist | Social Worker | 572 Titus Ave, Suite B, Rochester, NY 14617-3519 | 2007-04-02 |
| 1376614420 | Janet D. Kowal | Social Worker | 572 Titus Ave, Rochester, NY 14617-3519 | 2006-11-12 |
| 1093802084 | John E. Lambrix Corp. | Counselor | 572 Titus Ave, Rochester, NY 14617-3519 | 2006-10-10 |
| 1982792511 | John Edward Lambrix | Counselor | 572 Titus Ave, Rochester, NY 14617-3519 | 2006-10-10 |
| 1528178753 | Robert Steven Supple | Dentist | 572 Titus Ave, Rochester, NY 14617-3519 | 2006-08-30 |
| 1144232737 | Joanne Antinore Dermady | Counselor | 572 Titus Ave, Rochester, NY 14617-3519 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625148 | Taylor Barrett | Speech-Language Pathologist | 350 Cooper Road, Rochester, NY 14617 | 2019-12-04 |
| 1326517608 | Matthew Richard Vandermeid | Student in an Organized Health Care Education/Training Program | 161 Sethland Dr., Rochester, NY 14617 | 2018-11-16 |
| 1174031652 | Joseph Tshamala | Chiropractor | 2164 Hudson Ave., Rochester, NY 14617 | 2018-01-18 |
| 1043585599 | Shannon Nichole Fridd | Speech-Language Pathologist | 350 Cooper Rd., Rochester, NY 14617 | 2012-03-16 |
| 1861777112 | Todd M Schoen | Pharmacist | 525 Titus Avenue, Rochester, NY 14617 | 2011-10-19 |
| 1225317266 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 304 Daley Blvd, Rochester, NY 14617 | 2011-08-09 |
| 1407135445 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 404 Rogers Pkwy, Rochester, NY 14617 | 2011-08-09 |
| 1316226350 | Easter Seals of Ny, Inc | Intermediate Care Facility, Mental Illness | 302 Daley Boulevard, Rochester, NY 14617 | 2011-08-09 |
| 1215225602 | Alberto Ramon Cebollero | Psychologist | 402 Rogers Parkway, The Kessler Center, Rochester, NY 14617 | 2011-07-19 |
| 1487893269 | Stepping Stones Learning Center | Early Intervention Provider Agency | 2111 Hudson Ave, Rochester, NY 14617 | 2009-02-18 |
| Find all providers in zip 14617 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1124646856 | Brayana Lashay Dudley | Chiropractor | 25 Scott Ln, Rochester, NY 14624-3919 | 2020-07-09 |
| 1649897893 | Mary-margaret Baukol | Chiropractor | 275 37th St Ne Ste 200, Rochester, MN 55906-5438 | 2020-07-02 |
| 1073159489 | Anh Wellness Chiropractic Pllc | Chiropractor | 500 Helendale Rd Ste 160, Rochester, NY 14609-3125 | 2019-11-20 |
| 1477103042 | Caitlin R Simpson | Chiropractor | 1655 Elmwood Ave Ste 235, Rochester, NY 14620-3431 | 2019-09-16 |
| 1447721048 | Holly A Potter | Chiropractor | 2005 Lyell Ave Ste 115, Rochester, NY 14606-2325 | 2018-12-08 |
| 1306343819 | Christopher J Hartley | Chiropractor | 3257 19th St Nw Ste 1, Rochester, MN 55901-6797 | 2018-04-11 |
| 1316445349 | Hudson Family Chiropractic, Pllc | Chiropractor | 470 Long Pond Rd Ste 270f, Rochester, NY 14612 | 2018-01-24 |
| 1174031652 | Joseph Tshamala | Chiropractor | 2164 Hudson Ave., Rochester, NY 14617 | 2018-01-18 |
| 1598290884 | Rochester Chiropractic & Welln | Chiropractor | 3510 8th St Nw # 100, Rochester, MN 55901-5927 | 2017-04-25 |
| Find all providers in ROCHESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.