Individual
DR. JAY ALLEN SUPNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
448 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1608
(585) 424-5680
Mailing address
448 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1608
(585) 424-5680
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8678
NY
Other
Enumeration date
06/11/2006
Last updated
02/24/2011
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