Provider Demographics
NPI:1679297600
Name:INTERNAL MEDICINE OF BRIGHTON, PLLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE OF BRIGHTON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:GERARDO
Authorized Official - Last Name:CAHN-HIDALGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-424-5440
Mailing Address - Street 1:300 WHITE SPRUCE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1606
Mailing Address - Country:US
Mailing Address - Phone:585-424-5440
Mailing Address - Fax:585-427-2712
Practice Address - Street 1:300 WHITE SPRUCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1606
Practice Address - Country:US
Practice Address - Phone:585-424-5440
Practice Address - Fax:585-427-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty