MEDICARE: SACHIKO KAIZUKA MD

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	018797	ME
2	207Q00000X	Family Medicine Physician	284464	NY

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	:	1588854798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SACHIKO KAIZUKA MD

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE BOX 655
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-8655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-3527
Country	:	US
Telephone Number	:	585-275-9555
Fax Number	:

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

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	06/29/2023

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