Provider Demographics
NPI:1356360895
Name:ZOLLO, RAYMOND A (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:A
Last Name:ZOLLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 604
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-5982
Mailing Address - Fax:585-756-0169
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 604
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-5982
Practice Address - Fax:585-756-0169
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY200778207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG0189393590OtherBLUE CHOICE GROUP
NYMDE617OtherPREFERRED CARE
NY01962014Medicaid
NY050069594OtherRAILROAD MEDICARE
NY7048208OtherAETNA
NY00372225Medicaid
NYP010200778OtherBLUE CHOICE
NY2222OtherBLUE SHIELD GROUP
NY7048208OtherAETNA