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NPI Code Detail

MEDICARE: WESTSIDE ANESTHESIA ASSOCIATES OF ROCHESTER, LLP

MEDICARE: WESTSIDE ANESTHESIA ASSOCIATES OF ROCHESTER, LLP
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
1207L00000XAnesthesiology Physician

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 : 1871582601
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTSIDE ANESTHESIA ASSOCIATES OF ROCHESTER, LLP
Provider Business Mailing Address
First Line : PO BOX 2005
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-4505
Country : US
Telephone Number : 315-449-0513
Fax Number : 315-445-2936
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4122
Country : US
Telephone Number : 585-255-8966
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : VITO POTENZA
Credential : MD
Telephone Number : 585-255-8966
Provider Enumeration Date : 10/14/2005
Last Update Date : 06/29/2016

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