Provider Demographics
NPI:1689049181
Name:ROCHESTER BRAIN & SPINE GROUP PLLC
Entity Type:Organization
Organization Name:ROCHESTER BRAIN & SPINE GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-334-5560
Mailing Address - Street 1:400 RED CREEK DR STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4273
Mailing Address - Country:US
Mailing Address - Phone:585-334-5560
Mailing Address - Fax:
Practice Address - Street 1:400 RED CREEK DR STE 120
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4273
Practice Address - Country:US
Practice Address - Phone:585-334-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213927-1207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty