Healthcare Provider Details

I. General information

NPI: 1528020005
Provider Name (Legal Business Name): GENESEE ORTHOPAEDICS AND SPORTS MEDICINE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 01/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 CHANDLER AVE
BATAVIA NY
14020-1611
US

IV. Provider business mailing address

33 CHANDLER AVE
BATAVIA NY
14020-1611
US

V. Phone/Fax

Practice location:
  • Phone: 585-343-9676
  • Fax:
Mailing address:
  • Phone: 585-343-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW J LANDFRIED
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 585-343-9676