Individual
DR. CAROL ANN GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
497 BEAHAN RD, ROCHESTER, NY 14624-3403
(585) 247-5400
(585) 319-4124
Mailing address
497 BEAHAN RD, ROCHESTER, NY 14624-3403
(585) 247-5400
(585) 319-4124
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
193228
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010193228
BLUE CHOICE
NY
05
—
01613309
—
NY
01
—
101484DL
PREFERRED CARE
NY
01
—
3464
BLUE CROSS & BLUE SHIELD
NY
Enumeration date
01/18/2007
Last updated
06/30/2017
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