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General NPI Number Information
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NPI Number | 1346234382
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Entity Type | Individual
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Provider Name | DIETER W AFFELN MD
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Gender | Male
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 1425 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3011
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Country | US
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Telephone | 585-922-4173
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Fax | 585-922-5595
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Provider Business Mailing Address
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Address Line | 100 KINGS HWY S
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City | ROCHESTER
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State | NY
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Zip | 14617-5504
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Country | US
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Telephone | 585-922-4173
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Fax | 585-922-5595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 303227
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License Number State | NY
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