Organization
EDWARD C TANNER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD C TANNER MD (OWNER)
(585) 266-2583
Entity
Organization
Contact information
Practice address
1445 PORTLAND AVE, ROCHESTER, NY 14621
(585) 266-2583
(585) 266-5363
Mailing address
1445 PORTLAND AVE, ROCHESTER, NY 14621
(585) 266-2583
(585) 266-5363
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
14075 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00593559
—
NY
01
—
102336CU
PREFERRED CARE
—
Enumeration date
01/18/2007
Last updated
01/17/2008
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