MEDICARE: ROCHESTER VASCULAR MEDICINE, 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
1	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1942488309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCHESTER VASCULAR MEDICINE, PC

Provider Business Mailing Address
First Line	:	3525 BUFFALO RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1182
Country	:	US
Telephone Number	:	585-594-2000
Fax Number	:	585-594-2223

Provider Business Practice Location Address
First Line	:	3525 BUFFALO RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1182
Country	:	US
Telephone Number	:	585-594-2000
Fax Number	:	585-594-2223

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MALUR BALAJI
Credential	:	MD
Telephone Number	:	585-594-2000

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	03/27/2008

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