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NPI Code Detail

MEDICARE: DR. JEFFREY VUILLEQUEZ M.D.

MEDICARE: DR. JEFFREY VUILLEQUEZ M.D.
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
1207R00000XInternal Medicine Physician207592-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P010207592OTHERNYBLUE CHOICE
3101715BJOTHERNYPREFERRED CARE
47920441OTHERNYAETNA

General Provider Information

NPI Number : 1275533408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY VUILLEQUEZ M.D.
Provider Business Mailing Address
First Line : 100 KINGS HWY S STE 300
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1455 E RIDGE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14621-2006
Country : US
Telephone Number : 585-922-4101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 08/07/2025

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