National Provider Identifier
Blossom Road Medicine, PLLC
Blossom Road Medicine, PLLC is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Rochester, NY and a listed phone number of (585) 482-1141.
Profile Overview
- NPI
- 1376948893
- Provider Type
- Organization
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- October 27, 2014
- Last Updated
- June 14, 2023
Practice Location
- 780 Blossom RD
- Rochester, NY 14610-1914
Phone: (585) 482-1141
Specialties
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1376948893
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Blossom Road Medicine, PLLC
- Mailing Street Address
- 780 Blossom RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14610-1914
- Mailing Country
- US
- Mailing Phone
- (585) 482-1141
- Mailing Fax
- (585) 270-4153
- Practice Street Address
- 780 Blossom RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14610-1914
- Practice Country
- US
- Practice Phone
- (585) 482-1141
- Practice Fax
- (585) 270-4153
- Enumeration Date
- October 27, 2014
- Last Updated
- June 14, 2023
- Authorized Official Last Name
- Boehlert
- Authorized Official First Name
- Sandra
- Authorized Official Title
- Physician
- Authorized Official Phone
- (585) 482-1141
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- MS.
- Authorized Official Credential Text
- MD
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- June 14, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 1457343972 (NY, NPI 1)