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General NPI Number Information
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NPI Number | 1407703580
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Entity Type | Organization
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Legal Business Name | WESTSIDE PODIATRY GROUP LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 103 CANAL LANDING BLVD STE 12
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City | ROCHESTER
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State | NY
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Zip | 14626-5108
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Country | US
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Telephone | 585-225-2290
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Fax | 585-225-5323
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Provider Business Mailing Address
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Address Line | 103 CANAL LANDING BLVD STE 12
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City | ROCHESTER
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State | NY
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Zip | 14626-5108
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Country | US
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Telephone | 585-225-2290
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Fax | 585-225-5323
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRENDA MANGIONE
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Credential |
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Telephone | 585-225-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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