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NPI Code Detail

MEDICARE: INTERLAKES ONCOLOGY & HEMATOLOGY PC

MEDICARE: INTERLAKES ONCOLOGY & HEMATOLOGY PC
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
1207RH0003XHematology & Oncology PhysicianNY

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 : 1518936566
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERLAKES ONCOLOGY & HEMATOLOGY PC
Provider Business Mailing Address
First Line : 211 WHITE SPRUCE BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-1616
Country : US
Telephone Number : 585-475-8700
Fax Number : 585-475-9411
Provider Business Practice Location Address
First Line : 211 WHITE SPRUCE BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-1616
Country : US
Telephone Number : 585-475-8700
Fax Number : 585-475-9411
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. SUSAN BARBATO
Credential :
Telephone Number : 585-475-8727
Provider Enumeration Date : 03/14/2006
Last Update Date : 04/16/2014

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