Irondequoit Internal Medicine

LBN: Irondequoit Internal Medicine
Irondequoit Internal Medicine is an health care organization with primary practice located at 485 Titus Ave Ste H , Rochester NY 14617-3544. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Irondequoit Internal Medicine can be contacted via phone (585) 338-2530, or through Khishchenko, Larisa via phone (585) 338-2530.

Contact Information

Primary practice address
485 Titus Ave Ste H Rochester NY 14617-3544
Phone: (585) 338-2530
Fax: (585) 338-7304
Website:
Map and Directions
Authorized official contact:
Name: Khishchenko, Larisa Doctor of Medicine (MD)
Phone: (585) 338-2530

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 180528 New York

Profile Details

NPI number 1245375708
LBN Legal business name Irondequoit Internal Medicine
DBA Doing business as
Authorized official Khishchenko, Larisa Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245375708 NPPES
New York Other 102621BJ PREFERRED CARE
New York MEDICAID 01584647 PREFERRED CARE

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