Basic Information
Provider Information
NPI: 1356583447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PANZER
FirstName: ALLISON
MiddleName: M.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 EMWOOD AVE
Address2: BOX MED
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5852754912
FaxNumber: 5852762144
Practice Location
Address1: 601 EMWOOD AVE
Address2: BOX MED
City: ROCHESTER
State: NY
PostalCode: 146420001
CountryCode: US
TelephoneNumber: 5852754912
FaxNumber: 5852762144
Other Information
ProviderEnumerationDate: 04/03/2009
LastUpdateDate: 01/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X271263NYN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X271263NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home