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General NPI Number Information
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NPI Number | 1932370897
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Entity Type | Organization
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Legal Business Name | PITTSFORD FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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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 | 585-662-5680
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Fax | 585-662-5679
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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 | 585-662-5680
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Fax | 585-662-5679
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ERIC WILCOX
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Credential | D.O.
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Telephone | 585-662-5680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 243056
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License Number State | NY
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