MEDICARE: ROCHESTER CARDIOPULMONARY GROUP, P.C.

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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	200770893	OTHER	MVP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6890	OTHER	BLUE SHIELD
4	180309590	OTHER	BLUE CHOICE

General Provider Information

NPI Number	:	1710967534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCHESTER CARDIOPULMONARY GROUP, P.C.

Provider Business Mailing Address
First Line	:	30 HAGEN DR
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2658
Country	:	US
Telephone Number	:	585-338-2700
Fax Number	:	585-338-2738

Provider Business Practice Location Address
First Line	:	30 HAGEN DR
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2658
Country	:	US
Telephone Number	:	585-338-2700
Fax Number	:	585-338-2738

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. IHOR R. TROJAN
Credential	:
Telephone Number	:	585-922-6100

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	10/09/2013

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