Provider Demographics
NPI:1528020005
Name:GENESEE ORTHOPAEDICS AND SPORTS MEDICINE, LLP
Entity Type:Organization
Organization Name:GENESEE ORTHOPAEDICS AND SPORTS MEDICINE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANDFRIED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-343-9676
Mailing Address - Street 1:33 CHANDLER AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1611
Mailing Address - Country:US
Mailing Address - Phone:585-343-9676
Mailing Address - Fax:
Practice Address - Street 1:33 CHANDLER AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1611
Practice Address - Country:US
Practice Address - Phone:585-343-9676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
270031Medicare ID - Type Unspecified