Healthcare Provider Details

I. General information

NPI: 1154361442
Provider Name (Legal Business Name): THOMAS R ADLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 03/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 CANAL LANDING BLVD STE 7
ROCHESTER NY
14626-5112
US

IV. Provider business mailing address

99 CANAL LANDING BLVD STE 7
ROCHESTER NY
14626-5112
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-8710
  • Fax: 585-723-8395
Mailing address:
  • Phone: 585-723-8710
  • Fax: 585-723-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number179625
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: