MEDICARE: DR. LAURIE A PROIA 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
1	207RI0200X	Infectious Disease Physician	261114	NY

General Provider Information

NPI Number	:	1689635054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURIE A PROIA M.D.

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-723-7719
Fax Number	:	585-723-7834

Provider Business Practice Location Address
First Line	:	1561 LONG POND RD STE 220
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4135
Country	:	US
Telephone Number	:	585-723-7719
Fax Number	:	585-723-7834

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	01/09/2023

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