Basic Information
| Provider Information | |||||||||
| NPI: | 1164590568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARGISH | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 WINTON ROAD S. | ||||||||
| Address2: | JEWISH HOME OF ROCHESTER | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857846400 | ||||||||
| FaxNumber: | 5853412370 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 WINTON ROAD S. | ||||||||
| Address2: | JEWISH HOME OF ROCHESTER | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857846400 | ||||||||
| FaxNumber: | 5853412370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 12/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 36113681 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 253445 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207RG0300X | 253445 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.