Healthcare Provider Details

I. General information

NPI: 1689608549
Provider Name (Legal Business Name): MARGARET HAZZARD ORMANOSKI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/03/2023
Certification Date: 11/15/2022
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 648
ROCHESTER NY
14642-8648
US

V. Phone/Fax

Practice location:
  • Phone: 585-784-2985
  • Fax: 585-273-1033
Mailing address:
  • Phone: 585-275-2734
  • Fax: 585-273-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number199545
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number04137
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number04137
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number199545
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: