Provider Demographics
NPI:1982796033
Name:DERMATOLOGY PARTNERS OF WESTERN NEW YORK, LLP
Entity Type:Organization
Organization Name:DERMATOLOGY PARTNERS OF WESTERN NEW YORK, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WOJCIECHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-232-8940
Mailing Address - Street 1:30 N UNION ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1345
Mailing Address - Country:US
Mailing Address - Phone:585-232-8940
Mailing Address - Fax:585-232-8687
Practice Address - Street 1:30 N UNION ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1345
Practice Address - Country:US
Practice Address - Phone:585-232-8940
Practice Address - Fax:585-232-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0332Medicare ID - Type UnspecifiedGROUP MEDIARE NUMBER