Healthcare Provider Details

I. General information

NPI: 1598797987
Provider Name (Legal Business Name): ALLERGY ASSOCIATES OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GOODMAN ST S
ROCHESTER NY
14607-3105
US

IV. Provider business mailing address

300 GOODMAN ST S
ROCHESTER NY
14607-3105
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-2755
  • Fax: 585-271-7358
Mailing address:
  • Phone: 585-271-2755
  • Fax: 585-271-7358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRUCE FRANCIS CORSELLO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 585-271-2755