1063826402 NPI number — DR. FRANCIS B. PANOSYAN M.D.

Table of content: DR. FRANCIS B. PANOSYAN M.D. (NPI 1063826402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063826402 NPI number — DR. FRANCIS B. PANOSYAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANOSYAN
Provider First Name:
FRANCIS
Provider Middle Name:
B.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063826402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/15/2015
NPI Reactivation Date:
02/18/2015

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 673 601 ELMWOOD AVENUE
Provider Second Line Business Mailing Address:
NEUROMUSCULAR DISEASE UNIT, URMC
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14672
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-275-2762
Provider Business Mailing Address Fax Number:
585-273-1254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
607 ELMWOOD AVENUE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF ROCHESTER MEDICAL CENTER
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-275-4568
Provider Business Practice Location Address Fax Number:
585-273-1254
Provider Enumeration Date:
06/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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