PODIATRY AFFILIATE OF ROCHESTER PLLC NPI 1710490263

NPI Information

NPI: 1710490263
Provider Name: PODIATRY AFFILIATE OF ROCHESTER PLLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1500 PORTLAND AVENUE
PODIATRY/MEDICAL SUITE
ROCHESTER, NY
ZIP 14621
Phone: (585) 642-6100
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PODIATRY AFFILIATE OF ROCHESTER PLLC is a foot and ankle surgery podiatrist in Rochester, NY. PODIATRY AFFILIATE OF ROCHESTER PLLC NPI is 1710490263. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1500 PORTLAND AVENUE
PODIATRY/MEDICAL SUITE
ROCHESTER, NY
ZIP 14621-065
Phone: (585) 642-6100
Fax: (585) 642-6111

The provider's authorized official is John Ellie .
The authorized official title is Ceo/president and has the following contact phone number (585) 642-6100.

The enumeration date for this NPI number is 11/7/2017 and was last updated on 3/14/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	05448155	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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