Provider Demographics
NPI:1366535940
Name:GASTROENTEROLOGY GROUP OF ROCHESTER, LLP
Entity type:Organization
Organization Name:GASTROENTEROLOGY GROUP OF ROCHESTER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-271-2800
Mailing Address - Street 1:919 WESTFALL ROAD
Mailing Address - Street 2:BLDG C-100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-271-2800
Mailing Address - Fax:585-271-0375
Practice Address - Street 1:919 WESTFALL ROAD
Practice Address - Street 2:BLDG C-100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-271-2800
Practice Address - Fax:585-271-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG0183898590OtherEXCELLUS
NYCF8438OtherRAILROAD
NY02578343Medicaid
NY7082043OtherAETNA
NYG0183898590OtherEXCELLUS