Healthcare Provider Details

I. General information

NPI: 1033485487
Provider Name (Legal Business Name): CAROL FRIES SIMPSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL ALLISON FRIES MD

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 07/03/2023
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 777
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-9281
  • Fax: 585-273-1039
Mailing address:
  • Phone: 585-275-2981
  • Fax: 585-273-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number277449
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: