Provider Demographics
NPI:1902487093
Name:UNIVERSITY OF ROCHESTER
Entity type:Organization
Organization Name:UNIVERSITY OF ROCHESTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-275-3033
Mailing Address - Street 1:601 ELMWOOD AVE BOX 684
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-784-9503
Mailing Address - Fax:585-784-8207
Practice Address - Street 1:211 BAILEY RD
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9728
Practice Address - Country:US
Practice Address - Phone:585-275-8546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF ROCHESTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-20
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory