Healthcare Provider Details

I. General information

NPI: 1346258241
Provider Name (Legal Business Name): MUHLBAUER DERMATOPATHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 MONROE AVENUE SUITE B
PITTSFORD NY
14534
US

IV. Provider business mailing address

PO BOX 23930
ROCHESTER NY
14692
US

V. Phone/Fax

Practice location:
  • Phone: 585-586-5166
  • Fax: 585-586-1370
Mailing address:
  • Phone: 585-586-5166
  • Fax: 585-586-1370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: JAN E MUHLBAUER
Title or Position: LAB DIRECTOR
Credential: MD
Phone: 585-586-5166