Provider Demographics
NPI:1821037045
Name:MAYO, ROBERT R (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:MAYO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1425 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3001
Mailing Address - Country:US
Mailing Address - Phone:585-922-0400
Mailing Address - Fax:585-922-0455
Practice Address - Street 1:370 E RIDGE RD STE 20
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1239
Practice Address - Country:US
Practice Address - Phone:585-922-0401
Practice Address - Fax:585-922-0455
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY223686207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01131126/RGHMedicaid
NY02223861Medicaid
NY01131126/RGHMedicaid
NYJ400057568Medicare PIN