Organization
UNIVERSITY DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M HETTERICH (SENIOR DIRECTOR OF FINANCE URMFG)
(585) 756-4008
Entity
Organization
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-7546
Mailing address
601 ELMWOOD AVE BOX 278797, ROCHESTER, NY 14642-0001
(585) 487-1400
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00729171
—
NY
01
—
G0183268590
EXCELLUS OF ROCHESTER
NY
Enumeration date
06/24/2006
Last updated
08/11/2022
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