# PEDIATRIC NEONATAL

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

## Provider details

- **NPI number:** 1457364358
- **Authorized official:** MARTIN J HAIBACH (CFO)
- **Authorized official phone:** (585) 756-4010

## Contact information

- **Practice address:** 601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
- **Practice address phone:** (585) 275-7787
- **Mailing address:** 601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
- **Mailing address phone:** (585) 275-7787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 05/04/2010