Provider Demographics
NPI:1467090761
Name:COMMUNITY MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIERNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:585-210-4238
Mailing Address - Street 1:C/O TRILLIUM HEALTH, INC.
Mailing Address - Street 2:259 MONROE AVENUE, SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607
Mailing Address - Country:US
Mailing Address - Phone:585-545-7218
Mailing Address - Fax:
Practice Address - Street 1:COMMUNITY MEDICAL SERVICES, PC
Practice Address - Street 2:39 DELEVAN STREET
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605
Practice Address - Country:US
Practice Address - Phone:585-545-7218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty