Basic Information
| Provider Information | |||||||||
| NPI: | 1780626457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAYAS-COLON | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | P.O. BOX 648 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146428648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852752733 | ||||||||
| FaxNumber: | 5852731033 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146428648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852752733 | ||||||||
| FaxNumber: | 5852731033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 09/23/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 220937 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | D0069421 | MD | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 155103YVP | 01 | MD | MEDICARE 435L | OTHER | 155103YVQ | 01 | MD | MEDICARE 434L | OTHER | 155025YT7 | 01 | DC | MEDICARE G00000 | OTHER |