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General NPI Number Information
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NPI Number | 1346271871
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Entity Type | Organization
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Legal Business Name | WESTSIDE ORTHOPAEDIC GROUP P.C.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2211 LYELL AVE SUITE 107
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City | ROCHESTER
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State | NY
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Zip | 14606-5743
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Country | US
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Telephone | 585-429-6440
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Fax | 585-429-6661
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Provider Business Mailing Address
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Address Line | 2211 LYELL AVE SUITE 107
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City | ROCHESTER
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State | NY
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Zip | 14606-5743
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Country | US
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Telephone | 585-429-6440
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Fax | 585-429-6661
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GERRY DULNIK
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Credential | R.T.
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Telephone | 585-429-6440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 156391-1
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License Number State | NY
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