Organization Active NPI

Craniofacial Center of the University of Rochester

  • Plastic and Reconstructive Surgery Physician
  • Rochester, NY
National Provider Identifier
1417250648
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
CRANIOFACIAL CENTER OF THE UNIVERSITY OF ROCHESTER
Practice address
601 Elmwood Ave
Rochester, NY 14642-0001
Phone
(585) 275-1000
Fax
(585) 276-1985
NPI assigned
Dec 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Martin J Haibach
Title
Cfo
Phone
(585) 756-4010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

601 Elmwood Ave
Rochester, NY 14642-0001

Mailing address

601 Elmwood Ave
Box 661
Rochester, NY 14642-0001
Phone (585) 275-1000

National Provider Directory

National Provider Directory

Locations

601 Elmwood Ave
#661
Rochester, NY 14642
Phone (585) 275-3376

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1417250648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "address_2": "BOX 661",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-1000",
            "fax_number": "585-276-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-1000",
            "fax_number": "585-276-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANIOFACIAL CENTER OF THE UNIVERSITY OF ROCHESTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "HAIBACH",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "585-756-4010"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.