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General NPI Number Information
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NPI Number | 1811262082
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Entity Type | Organization
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Legal Business Name | DERDEN LLC
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 3000 MOUNT READ BLVD
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City | ROCHESTER
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State | NY
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Zip | 14616-4843
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Country | US
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Telephone | 585-865-3223
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Fax | 585-621-4128
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Provider Business Mailing Address
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Address Line | 388 GARDEN DR
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City | BATAVIA
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State | NY
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Zip | 14020-1767
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Country | US
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Telephone | 585-768-4670
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Fax | 585-768-4681
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. DENIZ M PIRINCCI
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Credential | M.D.
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Telephone | 585-768-4670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 177398
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License Number State | NY
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