Provider Demographics
NPI:1972065621
Name:LEVER, HAZEL AMELIA
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:AMELIA
Last Name:LEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ALEXANDER ST FL 4
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4039
Mailing Address - Country:US
Mailing Address - Phone:585-922-0527
Mailing Address - Fax:
Practice Address - Street 1:222 ALEXANDER ST FL 4
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4039
Practice Address - Country:US
Practice Address - Phone:585-922-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine