Provider Demographics
NPI:1437240231
Name:OCCUPATIONAL AND ENVIRONMENTAL MEDICINE
Entity Type:Organization
Organization Name:OCCUPATIONAL AND ENVIRONMENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARBONIT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:585-275-7795
Mailing Address - Street 1:910 WILLITS RD
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9380
Mailing Address - Country:US
Mailing Address - Phone:315-524-3358
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 654
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-8654
Practice Address - Country:US
Practice Address - Phone:585-275-7795
Practice Address - Fax:585-756-5326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215298261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY215298-1WOtherWORKERS' COMP
NYPO10215298OtherBLUE CHOICE