Healthcare Provider Details

I. General information

NPI: 1639172828
Provider Name (Legal Business Name): WESTFALL SURGERY CENTER LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 06/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 SENATOR KEATING BLVD.
ROCHESTER NY
14618
US

IV. Provider business mailing address

1065 SENATOR KEATING BLVD.
ROCHESTER NY
14618
US

V. Phone/Fax

Practice location:
  • Phone: 585-256-1330
  • Fax: 585-256-3823
Mailing address:
  • Phone: 585-256-1330
  • Fax: 585-256-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number2701227R
License Number StateNY

VIII. Authorized Official

Name: MR. GARY J. SCOTT
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 585-256-1330