Individual
DMITRY CHUPRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 PORTLAND AVE, SANDS CONSTELLATION HEART INSTITUTE, ROCHESTER, NY 14621-3001
(585) 442-5320
(585) 442-5526
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
(585) 442-5526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02652
NY
207RC0000X
Cardiovascular Disease Physician
02652
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
254668
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03014308
—
NY
01
—
BA1519
GROUP
NY
Enumeration date
08/31/2007
Last updated
09/06/2022
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