Provider Demographics
NPI:1346257458
Name:PRESBERG, SAUL LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:LLOYD
Last Name:PRESBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:OPHTHALMOLOGY
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-4794
Mailing Address - Fax:585-922-3635
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:OPHTHALMOLOGY
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-4794
Practice Address - Fax:585-922-3635
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY090588-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00464402Medicaid
NY100507CROtherPREFERRED CARE
NY4391832OtherAETNA
NYP010090588OtherEXCELLUS BLUE CHOICE
NY6049OtherEXCELLUS BLUE SHIELD
J400017820Medicare PIN
NYDD3401Medicare PIN
NY6049OtherEXCELLUS BLUE SHIELD
NYP010090588OtherEXCELLUS BLUE CHOICE