Provider Demographics
NPI:1750326153
Name:ROCHESTER COMMUNITY ORTHOPAEDICS, LLP
Entity Type:Organization
Organization Name:ROCHESTER COMMUNITY ORTHOPAEDICS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AMBROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-218-4337
Mailing Address - Street 1:20 HAGEN DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2657
Mailing Address - Country:US
Mailing Address - Phone:585-218-4337
Mailing Address - Fax:585-267-4037
Practice Address - Street 1:20 HAGEN DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2657
Practice Address - Country:US
Practice Address - Phone:585-218-4337
Practice Address - Fax:585-267-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01725002Medicaid
NY02318298Medicaid
NY00860384Medicaid
NY01613029Medicaid
NY00860384Medicaid
NY01613029Medicaid
NYRA0677Medicare PIN
NYB86191Medicare UPIN
NY01725002Medicaid
NYB72487Medicare UPIN