Elise W Van Der Jagt MD

NPI 1083650949 - Pediatrics - 208000000X

NPI Details
NPI 1083650949
Gender Male
Enumeration Date 06/21/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
601 ELMWOOD AVE
BOX 635
ROCHESTER NY, 14642-0001, US
Phone (585) 275-8138
Fax (585) 275-2352
Business Location
601 ELMWOOD AVE
BOX 635
ROCHESTER NY, 14642-0001, US
Phone (585) 275-8138
Fax (585) 275-2352
Toxanomy
Taxonomy Code 208000000X
License State New York
License Number 124938
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According to our database, Dr. Elise W Van Der Jagt MD NPI is 1083650949, taxonomy code is 208000000X and license number is 124938, license state is located at New York. Elise W Van Der Jagt MD physically located at 601 Elmwood Ave, Rochester NY, 14642-0001. NPI Number Elise W Van Der Jagt MD has the Individual type.

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1083650949 NPI number is provided on an as is basis without warranty of any kind. 1083650949 is maintained by the National Plan & Provider Enumeration System. The contents of Elise W Van Der Jagt MD are for informational purposes only.