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NPI Code Detail

MEDICARE: LEAH ROSSETT M.D.

MEDICARE:   LEAH  ROSSETT  M.D.
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
12085R0202XDiagnostic Radiology Physician68183WI
22085R0202XDiagnostic Radiology Physician297689NY
3363AM0700XMedical Physician Assistant297689NY

Other Identifiers

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

General Provider Information

NPI Number : 1518301787
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH ROSSETT M.D.
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE BOX 684
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-8648
Country : US
Telephone Number : 585-275-2734
Fax Number :
Provider Business Practice Location Address
First Line : 601 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number : 585-784-2985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2013
Last Update Date : 07/17/2023

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