Healthcare Provider Details

I. General information

NPI: 1053791558
Provider Name (Legal Business Name): EVAN VERBOFSKY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 RIDGE RD W
ROCHESTER NY
14624
US

IV. Provider business mailing address

2236 RIDGE RD W
ROCHESTER NY
14624
US

V. Phone/Fax

Practice location:
  • Phone: 585-225-9452
  • Fax: 585-225-5323
Mailing address:
  • Phone: 585-225-9452
  • Fax: 585-225-5323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006921
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: