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Organization
EARLENE C. SIEBOLD M.D.P.C,
Active
Organization
EARLENE C. SIEBOLD M.D.P.C,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARLENE C SIEBOLD MD (PHYSICIAN)
(585) 244-5630
Entity
Organization
Contact information
Practice address
880 WESTFALL RD, SUITE A, ROCHESTER, NY 14618-2611
(585) 244-5630
(585) 487-8250
Mailing address
880 WESTFALL RD STE A, ROCHESTER, NY 14618-2611
(585) 244-5630
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
156287
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01093163
—
NY
01
—
1045398
CAQH
NY
01
—
BB8505
PTAN
—
Enumeration date
07/21/2015
Last updated
06/28/2024
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