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:
Authorized official contact:
Name: Khishchenko, Larisa Doctor of Medicine (MD)
Phone: (585) 338-2530
Health care specialties
Specialty | Code | License # | 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 4 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245375708 | NPPES |
New York | Other | 102621BJ | PREFERRED CARE |
New York | MEDICAID | 01584647 | PREFERRED CARE |
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