Healthcare Provider Details

I. General information

NPI: 1821152588
Provider Name (Legal Business Name): UNIVERSITY OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 684
ROCHESTER NY
14642-0002
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 684
ROCHESTER NY
14642-0002
US

V. Phone/Fax

Practice location:
  • Phone: 585-784-8200
  • Fax: 585-784-8207
Mailing address:
  • Phone: 585-784-8200
  • Fax: 585-784-8207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2701005H
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2701005H
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2701005H
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2701005H
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2701005H
License Number StateNY

VIII. Authorized Official

Name: ADAM ANOLIK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 585-275-3033