Provider Demographics
NPI:1285432948
Name:EVIDENCE BASED WELLNESS MEDICINE PLLC
Entity type:Organization
Organization Name:EVIDENCE BASED WELLNESS MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-820-6093
Mailing Address - Street 1:54 TALNUCK DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-6008
Mailing Address - Country:US
Mailing Address - Phone:585-820-6093
Mailing Address - Fax:585-361-5514
Practice Address - Street 1:54 TALNUCK DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-6008
Practice Address - Country:US
Practice Address - Phone:585-820-6093
Practice Address - Fax:585-361-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003996745Medicaid