Healthcare Provider Details

I. General information

NPI: 1891183679
Provider Name (Legal Business Name): ST FINGER LAKES MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LYELL AVE SUITE 106
ROCHESTER NY
14606-5743
US

IV. Provider business mailing address

2211 LYELL AVE SUITE 106
ROCHESTER NY
14606-5743
US

V. Phone/Fax

Practice location:
  • Phone: 585-247-2000
  • Fax: 585-247-2004
Mailing address:
  • Phone: 585-247-2000
  • Fax: 585-247-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number241242
License Number StateNY

VIII. Authorized Official

Name: SVETLANA TROUNINA
Title or Position: MD
Credential: MD
Phone: 585-247-2000