Individual
MARY ROBIN MACINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, RN, NP
Contact information
Practice address
1415 PORTLAND AVE, STE 400, ROCHESTER, NY 14621-3038
(585) 922-4200
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
000617-1
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
360470-1
NY
367A00000X
Advanced Practice Midwife
Primary
000617
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000924350001
HEALTHNOW PROVIDER ID#
NY
05
—
01874840
—
NY
01
—
161568690
EMPIRE
NY
01
—
1899724
GHI PPO PROVIDER ID#
NY
01
—
7277063
AETNA PROVIDER ID NUMBER
NY
01
—
P010000617
BLUE CHOICE
NY
Enumeration date
10/04/2005
Last updated
11/19/2019
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