Individual
GREGORY D ROEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
200 WHITE SPRUCE BLVD, SUITE 134, ROCHESTER, NY 14623-1605
(585) 427-0270
(585) 427-0270
Mailing address
200 WHITE SPRUCE BLVD, SUITE 134, ROCHESTER, NY 14623-1605
(585) 427-0270
(585) 427-0270
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0084561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010008456
EXCELLUS BCBS ROCHESTER
NY
01
—
13071
MONROE PLAN
NY
01
—
P100267
PREFERRED CARE
NY
Enumeration date
06/02/2006
Last updated
04/19/2016
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