Provider Demographics
NPI:1265646103
Name:SURGICAL ASSOCIATES OF ROCHESTER, PC
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF ROCHESTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-332-3355
Mailing Address - Street 1:21 WHITEHALL RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3236
Mailing Address - Country:US
Mailing Address - Phone:603-332-3355
Mailing Address - Fax:603-335-0526
Practice Address - Street 1:21 WHITEHALL RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3236
Practice Address - Country:US
Practice Address - Phone:603-332-3355
Practice Address - Fax:603-335-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009168Medicaid
NH30009168Medicaid