Provider Demographics
NPI:1710283791
Name:ROCHESTER PHYSICIANS, PLLC
Entity Type:Organization
Organization Name:ROCHESTER PHYSICIANS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MATINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-342-4212
Mailing Address - Street 1:135 SULLYS TRL
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4564
Mailing Address - Country:US
Mailing Address - Phone:585-747-4226
Mailing Address - Fax:585-267-7536
Practice Address - Street 1:135 SULLYS TRL
Practice Address - Street 2:SUITE 5
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4564
Practice Address - Country:US
Practice Address - Phone:585-747-4226
Practice Address - Fax:585-267-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2203821207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty