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Organization
U OF R ANESTHESIOLOGY GROUP
Active
Organization
U OF R ANESTHESIOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA KING (BILLING MANAGER)
(585) 784-2451
Entity
Organization
Contact information
Practice address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5982
Mailing address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5982
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00372225
—
NY
01
—
0189393590
BLUE CHOICE GROUP NUMBER
NY
01
—
0189393591
BLUE CHOICE PTC GROUP NUM
NY
01
—
2222
BLUE SHIELD GROUP NUMBER
NY
01
—
CC0135
RAILROAD MEDICARE
NY
Enumeration date
07/04/2006
Last updated
02/24/2009
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