Organization
UNIVERSITY OF ROCHESTER SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M HETTERICH (SR. DIRECTOR OF FINANCE - URMFG)
(585) 756-4008
Entity
Organization
Contact information
Practice address
601 ELMWOOD AVE, BOX SURG, ROCHESTER, NY 14642-8410
(585) 275-1984
Mailing address
601 ELMWOOD AVE BOX SURG, ROCHESTER, NY 14642-8410
(585) 275-1984
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
NY
2086S0102X
Surgical Critical Care Physician
—
NY
2086S0120X
Pediatric Surgery Physician
—
NY
2086X0206X
Surgical Oncology Physician
—
NY
208C00000X
Colon & Rectal Surgery Physician
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01002868
—
NY
01
—
G0183916590
BLUE CHOICE
NY
Enumeration date
07/13/2006
Last updated
08/11/2022
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