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Organization
REACH PROGRAM
Active
Organization
REACH PROGRAM
Active
Parent organization
PEDIATRIC GROUP OF THE UNIVERSITY OF ROCHESTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC GROUP OF THE UNIVERSITY OF ROCHESTER
Authorized official
JENNIFER KNEBEL (BILLING MANAGER)
(585) 275-7787
Entity
Organization
Contact information
Practice address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787
(585) 275-2352
Mailing address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787
(585) 275-2352
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104511DL
PREFERRED CARE
NY
Enumeration date
03/30/2007
Last updated
07/21/2008
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