Provider Demographics
NPI:1073577961
Name:ROCHESTER OPHTHALMOLOGICAL GROUP, P.C.
Entity Type:Organization
Organization Name:ROCHESTER OPHTHALMOLOGICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:I
Authorized Official - Last Name:SCHENKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-244-6011
Mailing Address - Street 1:2100 S CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2616
Mailing Address - Country:US
Mailing Address - Phone:585-244-6011
Mailing Address - Fax:585-697-0413
Practice Address - Street 1:2100 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2616
Practice Address - Country:US
Practice Address - Phone:585-244-6011
Practice Address - Fax:585-697-0413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0194670001Medicare NSC
NY34395AMedicare PIN