Provider Demographics
NPI:1497030381
Name:ROCHESTER GENERAL HEALTH SYSTEM
Entity Type:Organization
Organization Name:ROCHESTER GENERAL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:RPA-C
Authorized Official - Phone:585-922-3963
Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:DEPARTMENT OF ORTHOPEDICS
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-3963
Mailing Address - Fax:585-266-5363
Practice Address - Street 1:1425 PORTLAND AVE
Practice Address - Street 2:DEPARTMENT OF ORTHOPEDICS
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3001
Practice Address - Country:US
Practice Address - Phone:585-922-3963
Practice Address - Fax:585-266-5363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015178282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital