Individual
CORAL L. SURGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1815 S CLINTON AVE, SUITE 610, ROCHESTER, NY 14618-5720
(585) 244-3430
(585) 244-7811
Mailing address
1815 CLINTON AVE S, SUITE 610, ROCHESTER, NY 14618-5720
(585) 244-3430
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
157602
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000914977001
BC/BS OF WESTERN NEW YORK
NY
01
—
000914977002
BC/BS OF WESTERN NEW YORK
NY
01
—
000914977003
BC/BS OF WESTERN NEW YORK
NY
05
—
00849803
—
NY
01
—
010157602
BLUE CHOICE
NY
01
—
0296919
GHI
NY
01
—
102458CK
PREFERRED CARE
NY
01
—
160009306
RAILROAD
NY
01
—
6184
BC/BS
NY
01
—
7849236
AETNA
NY
Enumeration date
04/07/2006
Last updated
07/08/2007
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