MEDICARE: MARK L SARNOV MD PLLC

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
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1588249262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK L SARNOV MD PLLC

Provider Business Mailing Address
First Line	:	1379 W RIDGE RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2412
Country	:	US
Telephone Number	:	585-684-3556
Fax Number	:	585-360-1701

Provider Business Practice Location Address
First Line	:	1379 W RIDGE RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2412
Country	:	US
Telephone Number	:	585-684-3556
Fax Number	:	585-360-1701

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK LARRY SARNOV
Credential	:	MD
Telephone Number	:	585-684-3556

Provider Enumeration Date	:	03/14/2021
Last Update Date	:	04/27/2024

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