Organization Active NPI

Soulitudes LLC

  • Health Service Clinic/Center
  • Fairport, NY
National Provider Identifier
1578885083
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
3375951 Issued in NY
Legal business name
SOULITUDES LLC
Practice address
1387 Fairport Rd
Building 500 Suite 520
Fairport, NY 14450-2003
Phone
(585) 377-1990
Fax
(585) 377-1997
NPI assigned
Feb 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bonnie Chudyk, N.D.
Title
Owner/President
Phone
(585) 377-1990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 3375951 NY Primary

Addresses

Primary practice location

1387 Fairport Rd
Building 500 Suite 520
Fairport, NY 14450-2003

Mailing address

1387 Fairport Rd
Building 500 Suite 520
Fairport, NY 14450-2003
Phone (585) 377-1990

Other names 1

  • SOULITUDES Wellness Center Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1578885083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "BUILDING 500 SUITE 520",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-377-1990",
            "fax_number": "585-377-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1387 FAIRPORT RD",
            "address_2": "BUILDING 500 SUITE 520",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502003",
            "telephone_number": "585-377-1990",
            "fax_number": "585-377-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULITUDES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-25",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "CHUDYK",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "585-377-1990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "3375951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOULITUDES Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.