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Organization
NORTHSIDE ECHOCARDIOGRAPHY, PC
Active
Organization
NORTHSIDE ECHOCARDIOGRAPHY, PC
Active
Other names
Laura J von Doenhoff, MD
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY MITCHELL (OFFICE MANAGER)
(585) 336-5050
Entity
Organization
Contact information
Practice address
1415 PORTLAND AVE, SUITE 555, ROCHESTER, NY 14621-3038
(585) 336-5050
(585) 336-5051
Mailing address
1415 PORTLAND AVE, SUITE 555, ROCHESTER, NY 14621-3038
(585) 336-5050
(585) 336-5051
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
131660
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00616633
—
NY
01
—
1013967074
NPI LAURA J VON DOENHOFF, MD
NY
01
—
17465B
MEDICARE PROVIDER ID#
NY
01
—
5309317
AETNA
NY
01
—
BA1217
MEDICARE PTAN
NY
01
—
MD4G96
PREFERRED CARE PROVIDER #
NY
01
—
N389329
WELLCARE
NY
01
—
P010131660
BLUE CHOICE PROVIDER ID
NY
Enumeration date
09/06/2007
Last updated
02/05/2010
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