Healthcare Provider Details

I. General information

NPI: 1639205891
Provider Name (Legal Business Name): ELAINE MARGARET TUNAITIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 WESTMINSTER RD
ROCHESTER NY
14607-2832
US

IV. Provider business mailing address

266 WESTMINSTER RD
ROCHESTER NY
14607-2832
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-4656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number135449-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number135449-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: