Provider Demographics
NPI:1518059195
Name:TRW AESTHETIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TRW AESTHETIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:DENNINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-249-1950
Mailing Address - Street 1:10 HAGEN DR
Mailing Address - Street 2:STE 310
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2660
Mailing Address - Country:US
Mailing Address - Phone:585-249-1950
Mailing Address - Fax:585-586-7558
Practice Address - Street 1:10 HAGEN DR
Practice Address - Street 2:STE 310
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2660
Practice Address - Country:US
Practice Address - Phone:585-249-1950
Practice Address - Fax:585-586-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty