Individual
DIANA CHADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
30 HAGEN DR, SUITE 100, ROCHESTER, NY 14625-2658
(585) 338-2700
(585) 242-9663
Mailing address
30 HAGEN DR, SUITE 100, ROCHESTER, NY 14625-2658
(585) 338-2700
(585) 242-9663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F304798
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F304798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000933778001
HEALTHNOW
—
01
—
000933778002
COMMUNITY BLUE
—
05
—
02976112
—
NY
01
—
090109000075
FIDELIS CARE
—
01
—
1144497983
MVP
—
01
—
PO193404798
BLUE CHOICE
—
Enumeration date
05/12/2008
Last updated
08/30/2022
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