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General NPI Number Information
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NPI Number | 1083027296
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Entity Type | Organization
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Legal Business Name | ROCHESTER MEDICAL WEIGHT LOSS, P.C
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 1299 PORTLAND AVE SUITE 7
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City | ROCHESTER
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State | NY
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Zip | 14621-2730
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Country | US
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Telephone | 585-467-9790
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Fax | 585-467-9798
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Provider Business Mailing Address
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Address Line | 1299 PORTLAND AVE SUITE 7
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City | ROCHESTER
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State | NY
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Zip | 14621-2730
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Country | US
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Telephone | 585-467-9790
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Fax | 585-467-9798
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GULE-RANA MASOOD
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Credential | MD
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Telephone | 585-467-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 190081
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License Number State | NY
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