Individual
KAZUHIRO HISAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-6402
(585) 275-2525
Mailing address
601 ELMWOOD AVE BOX SURG, ROCHESTER, NY 14642-0001
(852) 752-5255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
284767
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
284767
NY
363AM0700X
Medical Physician Assistant
284767
NY
Other
Enumeration date
12/04/2012
Last updated
07/07/2023
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