Healthcare Provider Details

I. General information

NPI: 1295260602
Provider Name (Legal Business Name): ALEXANDRA SAMBORSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2017
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LATTIMORE RD STE 200
ROCHESTER NY
14620-4155
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642-2969
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-3733
  • Fax:
Mailing address:
  • Phone: 585-275-3608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number311365
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: