Provider Demographics
NPI:1194885079
Name:WESTSIDE SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:WESTSIDE SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERREE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-247-4770
Mailing Address - Street 1:99 CANAL LANDING BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-5112
Mailing Address - Country:US
Mailing Address - Phone:585-247-4770
Mailing Address - Fax:585-247-4268
Practice Address - Street 1:99 CANAL LANDING BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-5112
Practice Address - Country:US
Practice Address - Phone:585-247-4770
Practice Address - Fax:585-247-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty