Healthcare Provider Details

I. General information

NPI: 1871609347
Provider Name (Legal Business Name): ROCHESTER VASCULAR SURGERY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 BUFFALO RD
ROCHESTER NY
14624-1119
US

IV. Provider business mailing address

3525 BUFFALO RD
ROCHESTER NY
14624-1119
US

V. Phone/Fax

Practice location:
  • Phone: 585-594-2000
  • Fax: 585-594-2223
Mailing address:
  • Phone: 585-594-2000
  • Fax: 585-594-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MALUR R BALAJI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 585-594-2000