Basic Information
| Provider Information | |||||||||
| NPI: | 1588063010 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NWE | ||||||||
| FirstName: | AYE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 KINGS HWY S | ||||||||
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| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146175504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859221318 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1425 PORTLAND AVE | ||||||||
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| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146213001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859225067 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 290010 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 290010 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.