Healthcare Provider Details

I. General information

NPI: 1780601872
Provider Name (Legal Business Name): IGNACIO E SANZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 LAC DE VILLE BLVD BLDG D SUITE 240
ROCHESTER NY
14618-5647
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-7900
  • Fax: 585-340-5399
Mailing address:
  • Phone: 585-275-1646
  • Fax: 585-276-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number203843
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: