Healthcare Provider Details

I. General information

NPI: 1609378108
Provider Name (Legal Business Name): UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1672 EMPIRE BLVD STE 100
WEBSTER NY
14580-2199
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 665
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-276-8590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILL M HETTERICH
Title or Position: SENIOR DIRECTOR OF FINANCE URMFG
Credential:
Phone: 585-756-4003