Organization
MAXWELL BOEV MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESSA ROSENBERG (BILLING MANAGER)
(585) 267-7510
Entity
Organization
Contact information
Practice address
1445 PORTLAND AVE, SUITE 304, ROCHESTER, NY 14621-3036
(585) 342-7170
Mailing address
90 OFFICE PKWY, LOWER LEVEL, PITTSFORD, NY 14534-1749
(585) 267-7510
(585) 267-7511
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
137227
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03436082
—
NY
Enumeration date
06/15/2012
Last updated
01/29/2013
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