Provider Demographics
NPI:1942783766
Name:UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER
Entity Type:Organization
Organization Name:UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER
Other - Org Name:PODIATRY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR DIRECTOR OF FINANCE, URMFG
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HETTERICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-756-4003
Mailing Address - Street 1:601 ELMWOOD AVE BOX 665
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-784-9662
Mailing Address - Fax:
Practice Address - Street 1:1672 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2199
Practice Address - Country:US
Practice Address - Phone:585-275-5321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY ORTHOPAEDIC ASSOCIATES OF ROCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty