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Organization
LATTIMORE PRIMARY CARE MEDICINE, PLLC
Active
Organization
LATTIMORE PRIMARY CARE MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL P MAGGIO MD (OWNER)
(585) 271-5250
Entity
Organization
Contact information
Practice address
560 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1613
(585) 271-5250
(585) 271-0129
Mailing address
560 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1613
(585) 271-5250
(585) 271-0129
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
161925
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1392
EXCELLUS
NY
01
—
MD198C
MVP
NY
Enumeration date
03/22/2013
Last updated
03/22/2013
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