| Internal Medicine On East Ridge, Llc | |
|
1880 East Ridge Road, Suite 5 Rochester NY 14622 | |
| (585) 697-7775 | |
| (585) 697-7776 |
| Full Name | Internal Medicine On East Ridge, Llc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 1880 East Ridge Road, Suite 5, Rochester, New York |
| Authorized Official Name and Position | Brenda Jean Iannucci (PHYSICIAN OWNER) |
| Authorized Official Contact | 5856977775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine On East Ridge, Llc 1880 East Ridge Road, Suite 5 Rochester NY 14622 Ph: (585) 697-7775 | Internal Medicine On East Ridge, Llc 1880 East Ridge Road, Suite 5 Rochester NY 14622 Ph: (585) 697-7775 |
| NPI Number | 1306058433 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306058433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 196460 (New York) | Primary |
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