Individual
MR. ERIC THOMAS MUNDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
393 PEMBERTON ROAD, ROCHESTER, NY 14622
(585) 317-0683
Mailing address
393 PEMBERTON ROAD, ROCHESTER, NY 14622
(585) 317-0683
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025435
NY
390200000X
Student in an Organized Health Care Education/Training Program
25435
NY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/25/2018
Last updated
07/03/2023
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