Individual
KATHLEEN ANN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
601 ELMWOOD AVE, BOX MED-HMD, ROCHESTER, NY 14642-0001
(585) 273-1636
(585) 276-2212
Mailing address
601 ELMWOOD AVE, BOX MED-HMD, ROCHESTER, NY 14642-0001
(585) 273-1636
(585) 276-2212
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
303325
NY
363L00000X
Nurse Practitioner
Primary
F3033251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02757606
—
NY
Enumeration date
06/10/2006
Last updated
07/05/2023
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