Basic Information
| Provider Information | |||||||||
| NPI: | 1235180175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSKVIG | ||||||||
| FirstName: | ROGER | ||||||||
| MiddleName: | MELVIN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 990 SOUTH AVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146202740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853416775 | ||||||||
| FaxNumber: | 5853418310 | ||||||||
| Practice Location | |||||||||
| Address1: | 990 SOUTH AVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146202740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853416775 | ||||||||
| FaxNumber: | 5853418310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 08/07/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 178365 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | 178365 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.