MEDICARE: THOMAS JOHN MCELLIGOTT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	138557	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417998360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JOHN MCELLIGOTT MD

Provider Business Mailing Address
First Line	:	89 GENESEE ST
Second Line	:	UNITY HEALTH REACH
City	:	ROCHESTER
State	:	NY
Zip	:	14611-3201
Country	:	US
Telephone Number	:	585-368-3720
Fax Number	:	585-368-3723

Provider Business Practice Location Address
First Line	:	89 GENESEE ST
Second Line	:	UNITY HEALTH REACH
City	:	ROCHESTER
State	:	NY
Zip	:	14611-3201
Country	:	US
Telephone Number	:	585-368-3720
Fax Number	:	585-368-3723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	09/15/2016

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