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General NPI Number Information
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NPI Number | 1235140252
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Entity Type | Organization
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Legal Business Name | ROCHESTER UROLOGY GROUP, PLLC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 2615 CULVER RD SUITE 100
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City | ROCHESTER
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State | NY
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Zip | 14609-1746
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Country | US
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Telephone | 585-336-5320
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Fax | 585-336-9114
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Provider Business Mailing Address
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Address Line | 2615 CULVER RD SUITE 100
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City | ROCHESTER
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State | NY
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Zip | 14609-1746
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Country | US
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Telephone | 585-336-5320
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Fax | 585-336-9114
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Authorized Official
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Title or Position | M.D.
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Name | MR. ABRAHAM A GLAZER
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Credential | M.D.
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Telephone | 585-227-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | NY
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