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Organization
UPSTATE VASCULAR STUDY LAB, INC
Active
Organization
UPSTATE VASCULAR STUDY LAB, INC
Active
Other names
Upstate Vascular Study Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY A. BURGEN (OFFICE MANAGER)
(585) 720-0818
Entity
Organization
Contact information
Practice address
2655 RIDGEWAY AVENUE, SUITE # 260, ROCHESTER, NY 14626
(585) 720-0818
(585) 720-5427
Mailing address
2655 RIDGEWAY AVENUE, SUITE # 260, ROCHESTER, NY 14626
(585) 720-0818
(585) 720-5427
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
124377
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00446135
—
NY
Enumeration date
04/26/2006
Last updated
02/06/2012
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