| Irondequoit Chiropractic Center | |
|
2164 Hudson Ave Rochester NY 14617-3960 | |
| (585) 467-7070 | |
| (585) 467-7702 |
| Full Name | Irondequoit Chiropractic Center |
|---|---|
| Speciality | General Practice |
| Location | 2164 Hudson Ave, Rochester, New York |
| Authorized Official Name and Position | Lawrence Charles Peshkin (OWNER) |
| Authorized Official Contact | 5854677070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irondequoit Chiropractic Center 2164 Hudson Ave Rochester NY 14617-3960 Ph: (585) 467-7070 | Irondequoit Chiropractic Center 2164 Hudson Ave Rochester NY 14617-3960 Ph: (585) 467-7070 |
| NPI Number | 1285205286 |
|---|---|
| Provider Enumeration Date | 07/09/2021 |
| Last Update Date | 02/20/2026 |
| Certification Date | 02/20/2026 |
| Medicare PECOS PAC ID | 8224432562 |
|---|---|
| Medicare Enrollment ID | O20210809000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285205286 | NPI | - | NPPES |
| 1447775366 | Medicaid | NY | |
| 1447775366 | Other | NY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Stephen T Gordon |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528388956 PECOS PAC ID: 2264602994 Enrollment ID: I20110907000832 |
| Provider Name | Lawrence C Peshkin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1447775366 PECOS PAC ID: 4981009768 Enrollment ID: I20210817000983 |
| Provider Name | Fernando G Alicea Quintana |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245819929 PECOS PAC ID: 3678978467 Enrollment ID: I20210817001539 |
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