Healthcare Provider Details

I. General information

NPI: 1710967534
Provider Name (Legal Business Name): ROCHESTER CARDIOPULMONARY GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HAGEN DR SUITE 100
ROCHESTER NY
14625-2658
US

IV. Provider business mailing address

30 HAGEN DR SUITE 100
ROCHESTER NY
14625-2658
US

V. Phone/Fax

Practice location:
  • Phone: 585-338-2700
  • Fax: 585-338-2738
Mailing address:
  • Phone: 585-338-2700
  • Fax: 585-338-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. IHOR R. TROJAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 585-922-6100