Individual
DEIRDRE COLGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 DRIVING PARK AVENUE, PO BOX 111, NEWARK, NY 14513-1090
(315) 359-2557
(315) 359-2248
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 723-7575
(585) 368-4890
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
269623
NY
207RP1001X
Pulmonary Disease Physician
Primary
269623
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04464600
—
NY
Enumeration date
04/03/2009
Last updated
01/27/2022
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