Individual
IAN ST. JOHN NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2220 S CLINTON AVE, ROCHESTER, NY 14618-2622
(585) 469-9582
Mailing address
2220 S CLINTON AVE, ROCHESTER, NY 14618-2622
(585) 469-9582
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
953682180
NY
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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