Provider Demographics
NPI:1760520274
Name:MERIT MEDICAL PRACTICE, PC
Entity Type:Organization
Organization Name:MERIT MEDICAL PRACTICE, PC
Other - Org Name:RHEUMATOLOGY ASSOICATES OF ROCHSTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHLOTZHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:5852880530
Authorized Official - Phone:585-288-0530
Mailing Address - Street 1:500 HELENDALE RD
Mailing Address - Street 2:SUITE 90
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-3173
Mailing Address - Country:US
Mailing Address - Phone:585-288-0530
Mailing Address - Fax:585-288-3363
Practice Address - Street 1:500 HELENDALE RD
Practice Address - Street 2:SUITE 90
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3173
Practice Address - Country:US
Practice Address - Phone:585-288-0530
Practice Address - Fax:585-288-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0637OtherMEDICARE
NYG0188846590OtherEXCELLUS
NY02042262OtherMEDICAID