Provider Demographics
NPI:1619944865
Name:DEJOY, PATRICIA ELLEN (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ELLEN
Last Name:DEJOY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ALLENS CREEK RD
Mailing Address - Street 2:BLDG 1 SUITE 313
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3250
Mailing Address - Country:US
Mailing Address - Phone:585-286-9188
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK RD
Practice Address - Street 2:BLDG 1 SUITE 313
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3250
Practice Address - Country:US
Practice Address - Phone:585-286-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP020009168OtherBLUE CROSS/BLUE SHIELD
NY7949244OtherAETNA
NYP010119168OtherBLUE CHOICE
NYC09168-8WOtherWORKER'S COMP
NYP010119168OtherBLUE CHOICE
NYU83109Medicare UPIN