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General NPI Number Information
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NPI Number | 1912438342
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Entity Type | Organization
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Legal Business Name | WILLIAM J. BROREIN, JR., M.D., PH.D.
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 2237 CLINTON AVE S
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City | ROCHESTER
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State | NY
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Zip | 14618-2623
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Country | US
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Telephone | 585-461-9600
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Fax | 585-461-9437
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Provider Business Mailing Address
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Address Line | 2237 CLINTON AVE S
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City | ROCHESTER
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State | NY
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Zip | 14618-2623
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Country | US
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Telephone | 585-461-9600
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Fax | 585-461-9437
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WILLIAM JACOB BROREIN II
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Credential | M.D., PH.D.
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Telephone | 585-461-9600
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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 | 170217
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License Number State | NY
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