Organization
UNIVERSITY UROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M HETTERICH (SR. DIRECTOR OF FINANCE-URMFG)
(585) 756-4003
Entity
Organization
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-5282
(585) 275-2498
Mailing address
601 ELMWOOD AVE BOX 278911, ROCHESTER, NY 14642-0001
(585) 756-4011
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
2088P0231X
Pediatric Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02561580
—
NY
01
—
DA0537
MEDICARE RR
NY
Enumeration date
05/26/2006
Last updated
10/25/2017
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