Provider Demographics
NPI:1942488309
Name:ROCHESTER VASCULAR MEDICINE, PC
Entity Type:Organization
Organization Name:ROCHESTER VASCULAR MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-594-2000
Mailing Address - Street 1:3525 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1182
Mailing Address - Country:US
Mailing Address - Phone:585-594-2000
Mailing Address - Fax:585-594-2223
Practice Address - Street 1:3525 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1182
Practice Address - Country:US
Practice Address - Phone:585-594-2000
Practice Address - Fax:585-594-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty