Healthcare Provider Details

I. General information

NPI: 1124276084
Provider Name (Legal Business Name): BHAVPREET SINGH DHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 WESTFALL RD STE 220
ROCHESTER NY
14618-2628
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 278984
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-7500
  • Fax: 585-341-7510
Mailing address:
  • Phone: 585-784-9277
  • Fax: 585-424-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number288691
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: