Provider Demographics
NPI:1174632285
Name:DERMATOLOGY ASSOCIATES OF ROCHESTER, PC
Entity Type:Organization
Organization Name:DERMATOLOGY ASSOCIATES OF ROCHESTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:585-272-0700
Mailing Address - Street 1:100 WHITE SPRUCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1507
Mailing Address - Country:US
Mailing Address - Phone:585-272-0700
Mailing Address - Fax:585-697-0822
Practice Address - Street 1:100 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1507
Practice Address - Country:US
Practice Address - Phone:585-272-0700
Practice Address - Fax:585-697-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty