Provider Demographics
NPI:1194759993
Name:DORSEY, E RAY (MD)
Entity type:Individual
Prefix:DR
First Name:E
Middle Name:RAY
Last Name:DORSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 278984
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-341-7500
Mailing Address - Fax:585-341-7510
Practice Address - Street 1:919 WESTFALL RD.
Practice Address - Street 2:BLDG C, SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2628
Practice Address - Country:US
Practice Address - Phone:585-341-7500
Practice Address - Fax:585-341-7510
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2373412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02708107Medicaid
NY143981Medicare UPIN
NYRA8378Medicare PIN