# UNIVERSITY CARDIOTHORACIC SURGERY GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154342285
- **Authorized official:** JILL M HETTERICH (SENIOR DIRECTOR OF FINANCE URMFG)
- **Authorized official phone:** (585) 756-4003

## Contact information

- **Practice address:** 601 ELMWOOD AVE, BOX SURG, ROCHESTER, NY 14642-0001
- **Practice address phone:** (585) 275-5384
- **Practice address fax:** (585) 244-7171
- **Mailing address:** 601 ELMWOOD AVE BOX SURG, ROCHESTER, NY 14642-0001
- **Mailing address phone:** (585) 275-6340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NY | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01389784 | — | NY |