Basic Information
| Provider Information | |||||||||
| NPI: | 1255346904 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEUROLOGY CONSULTANTS OF ROCHESTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 SULLYS TRL | ||||||||
| Address2: | BLDG 20 | ||||||||
| City: | PITTSFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145344552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855447979 | ||||||||
| FaxNumber: | 5855447901 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 SULLYS TRL | ||||||||
| Address2: | BLDG 20 | ||||||||
| City: | PITTSFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145344552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855447979 | ||||||||
| FaxNumber: | 5855447901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 06/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | LESSER | ||||||||
| AuthorizedOfficialFirstName: | HAROLD | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5855447979 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0600X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Clinical Neurophysiology | 2084N0400X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.