Individual
ENZO FALLONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 PORTLAND AVENUE, PATHOLOGY, ROCHESTER, NY 14621
(585) 922-4121
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
238815
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
238815-1
NY
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
238815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165492
GHI
NY
05
—
02911475
—
NY
01
—
7242958
AETNA
NY
Enumeration date
04/03/2007
Last updated
09/22/2022
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