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NPI Code Detail

MEDICARE: DR. SAMUEL URRUTIA FRAGUADA MD

MEDICARE: DR. SAMUEL URRUTIA FRAGUADA 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
1207R00000XInternal Medicine Physician340961NY
2207R00000XInternal Medicine PhysicianMD61526346WA

General Provider Information

NPI Number : 1982280525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL URRUTIA FRAGUADA MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 833 CANANDAIGUA RD
Second Line :
City : GENEVA
State : NY
Zip : 14456-2015
Country : US
Telephone Number : 315-787-5155
Fax Number : 315-787-5151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 12/15/2025

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