Healthcare Provider Details

I. General information

NPI: 1871515031
Provider Name (Legal Business Name): JOSEPH BLISS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-2401
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 651
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-9767
  • Fax: 585-461-3614
Mailing address:
  • Phone: 585-275-9767
  • Fax: 585-461-3614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number215277
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: