Organization
STEPHEN EVANGELISTI MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN EVANGELISTI MD (OWNER)
(585) 325-1120
Entity
Organization
Contact information
Practice address
1901 LAC DE VILLE BLVD STE 2, ROCHESTER, NY 14618-5660
(585) 325-1120
(585) 423-0471
Mailing address
1901 LAC DE VILLE BLVD STE 2, ROCHESTER, NY 14618-5660
(585) 325-1120
(585) 423-0471
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
173597-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01669589
—
NY
Enumeration date
02/02/2018
Last updated
02/02/2018
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