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Individual

JOHN THOMASSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
103 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1610
(585) 292-5830
Mailing address
831 W BLOOMFIELD RD, HONEOYE FALLS, NY 14472-9326

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009938-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027548
VALUE OPTIONS
01
156779FC
PREFERRED CARE
NY
01
7283460
AENTA
NY
Enumeration date
01/19/2007
Last updated
07/09/2007
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