National Provider Identifier
Michael Superdock, MD
Michael Superdock, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 275-5681.
Profile Overview
- NPI
- 1376164624
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 28, 2020
- Last Updated
- April 28, 2020
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-0001
Phone: (585) 275-5681
Mailing Address
- 111 Lena St Apt 412
- Ithaca, NY 14850-6901
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1376164624
- Entity Type
- Individual
- Last Name
- Superdock
- First Name
- Michael
- Credential
- MD
- Mailing Street Address
- 111 Lena St Apt 412
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-6901
- Mailing Country
- US
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 275-5681
- Practice Fax
- (585) 273-1041
- Enumeration Date
- April 28, 2020
- Last Updated
- April 28, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 28, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)