Basic Information
| Provider Information | |||||||||
| NPI: | 1174990303 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ROCHESTER GENERAL HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RRH FAMILY MEDICINE @RIT | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 181 LOMB MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146235608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859223100 | ||||||||
| FaxNumber: | 5859223106 | ||||||||
| Practice Location | |||||||||
| Address1: | 181 LOMB MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146235608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859223100 | ||||||||
| FaxNumber: | 5859223106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2015 | ||||||||
| LastUpdateDate: | 09/18/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | TINCH | ||||||||
| AuthorizedOfficialFirstName: | PAULA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT-FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 5859221223 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.