Individual
DR. JEFFREY BAZARIAN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4901 LAC DE VILLE BLVD, SUITE 250, ROCHESTER, NY 14618-5647
(585) 275-3271
(585) 442-2949
Mailing address
601 ELMWOOD AVE, BOX 655C, ROCHESTER, NY 14642-0001
(585) 341-3015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
176211
NY
207R00000X
Internal Medicine Physician
176211
NY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
176211
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01720850
—
NY
Enumeration date
07/17/2006
Last updated
07/03/2023
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