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General NPI Number Information
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NPI Number | 1154447324
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Entity Type | Organization
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Legal Business Name | RIDGEWOOD MEDICAL GROUP LLP
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 2081 W RIDGE RD SUITE 205
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City | ROCHESTER
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State | NY
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Zip | 14626-2724
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Country | US
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Telephone | 585-227-4560
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Fax | 585-227-4608
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Provider Business Mailing Address
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Address Line | 2081 W RIDGE RD SUITE 205
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City | ROCHESTER
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State | NY
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Zip | 14626-2724
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Country | US
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Telephone | 585-227-4560
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Fax | 585-227-4608
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Authorized Official
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Title or Position | PARTNER
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Name | MICHAEL T HERBOWY
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Credential | MD
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Telephone | 585-227-5157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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