MEDICARE: PLUTA FAMILY CANCER CENTER

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	261Q00000X	Clinic/Center	2701233R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	108811CA	OTHER	NY	PREFERRED CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	G0185964590	OTHER	NY	BLUE CHOICE

General Provider Information

NPI Number	:	1942231295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLUTA FAMILY CANCER CENTER

Provider Business Mailing Address
First Line	:	125 RED CREEK DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4272
Country	:	US
Telephone Number	:	585-486-0600
Fax Number	:	585-486-0649

Provider Business Practice Location Address
First Line	:	125 RED CREEK DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-4272
Country	:	US
Telephone Number	:	585-486-0600
Fax Number	:	585-486-0649

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	JOHN T TURO
Credential	:
Telephone Number	:	585-486-0581

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/30/2008

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Directions to “PLUTA FAMILY CANCER CENTER ” Practice Location

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