Provider Demographics
NPI:1154040400
Name:DIFLORIO, PATRICK (LMSW)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:DIFLORIO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PANORAMA TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2432
Mailing Address - Country:US
Mailing Address - Phone:585-865-3584
Mailing Address - Fax:
Practice Address - Street 1:625 PANORAMA TRL STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2432
Practice Address - Country:US
Practice Address - Phone:585-865-3584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111951104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker