| Ny Wound Care Medical Group | |
|
200 White Spruce Blvd Ste 134 Rochester NY 14623-1605 | |
| (323) 480-4075 | |
| Not Available |
| Full Name | Ny Wound Care Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 200 White Spruce Blvd Ste 134, Rochester, New York |
| Authorized Official Name and Position | Owen Bernardo Ellington (PRESIDENT) |
| Authorized Official Contact | 7133044227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ny Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 | Ny Wound Care Medical Group 200 White Spruce Blvd Ste 134 Rochester NY 14623-1605 Ph: (323) 480-4075 |
| NPI Number | 1932817996 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932817996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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