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General NPI Number Information
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NPI Number | 1932279395
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Entity Type | Individual
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Provider Name | BERNARD J OSEROFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3170 WEST ST SUITE 275
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1712
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Country | US
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Telephone | 585-394-0700
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Fax | 585-394-5051
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Provider Business Mailing Address
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Address Line | 3170 WEST STREET SUITE 275
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City | CANANDAIGUA
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State | NY
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Zip | 14424
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Country | US
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Telephone | 585-394-0700
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Fax | 585-394-5051
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 073717-1
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License Number State | NY
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