Individual
ANDREW SCOTT UDKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-3113
(585) 275-2821
Mailing address
601 ELMWOOD AVE BOX 632, ROCHESTER, NY 14642-0001
(585) 275-2821
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
382750
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382750
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04843674
—
NY
Enumeration date
06/18/2017
Last updated
07/17/2023
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