Provider Demographics
NPI:1912942269
Name:UROLOGY ASSOCIATES OF ROCHESTER
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF ROCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-608-8700
Mailing Address - Street 1:PO BOX 8000, DEPT 441
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:585-232-2980
Mailing Address - Fax:585-232-6522
Practice Address - Street 1:995 SENATOR KEATING BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2775
Practice Address - Country:US
Practice Address - Phone:585-232-2980
Practice Address - Fax:585-232-6522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146560208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10583AMedicare PIN