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NPI Code Detail

MEDICARE: LAURIE O'TOOLE PA

MEDICARE: LAURIE O'TOOLE PA
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
1363A00000XPhysician Assistant007519NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316024490
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE O'TOOLE PA
Provider Business Mailing Address
First Line : 293 UPPER FALLS BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2184
Country : US
Telephone Number : 585-922-0200
Fax Number :
Provider Business Practice Location Address
First Line : 293 UPPER FALLS BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2184
Country : US
Telephone Number : 585-922-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/19/2009

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Directions to “ LAURIE O'TOOLE PA” Practice Location

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