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General NPI Number Information
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NPI Number | 1710235536
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DERMATOLOGY OF ROCHESTER, PLLC
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 135 SULLYS TRL SUITE 7
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City | PITTSFORD
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State | NY
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Zip | 14534-4564
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Country | US
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Telephone | 585-381-5800
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Fax | 585-348-9461
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Provider Business Mailing Address
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Address Line | 135 SULLYS TRL SUITE 7
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City | PITTSFORD
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State | NY
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Zip | 14534-4564
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Country | US
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Telephone | 585-381-5800
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Fax | 585-348-9461
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MANASI KADAM LADRIGAN
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Credential | MD
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Telephone | 585-381-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2424371
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License Number State | NY
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