Provider Demographics
NPI:1821152588
Name:UNIVERSITY OF ROCHESTER
Entity Type:Organization
Organization Name:UNIVERSITY OF ROCHESTER
Other - Org Name:STRONG MEMORIAL HOSPITAL MD GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOLIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-275-3033
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 684
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0002
Mailing Address - Country:US
Mailing Address - Phone:585-784-8200
Mailing Address - Fax:585-784-8207
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 684
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0002
Practice Address - Country:US
Practice Address - Phone:585-784-8200
Practice Address - Fax:585-784-8207
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ROCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2701005H207R00000X, 207RH0003X, 207ZP0101X, 2084P0800X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03000406Medicaid
NY03000406Medicaid