Individual
DR. JEFFERSON SVENGSOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(525) 341-3002
(585) 473-3516
Mailing address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(525) 341-3002
(585) 473-3516
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
211296
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
211296
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02178554
—
NY
Enumeration date
07/10/2006
Last updated
07/05/2023
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