MEDICARE: ERIC AU DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	339859	NY

General Provider Information

NPI Number	:	1265176457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC AU DO

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	279 EAST AVE
Second Line	:
City	:	HILTON
State	:	NY
Zip	:	14468-1333
Country	:	US
Telephone Number	:	585-392-9100
Fax Number	:	585-392-6292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2022
Last Update Date	:	11/03/2025

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1457318198 — ROBERT EUGENE BLACKBURN M.D.
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1164489803 — BENSON LOUIS ZOGHLIN M.D.
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Practice Location Address:

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1881849388 — KATHERINE S EXTER FNP
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Directions to “ ERIC AU DO” Practice Location

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