Healthcare Provider Details

I. General information

NPI: 1386801637
Provider Name (Legal Business Name): UNIVETSITY OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

44 LILAC DR APT 4
ROCHESTER NY
14620-3256
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6855
  • Fax:
Mailing address:
  • Phone: 585-413-3320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number556465-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number StateNY

VIII. Authorized Official

Name: MS. IRLANDE ROBILLARD
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 585-413-3320