Individual
DR. JANE VAN DIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE DEPT OBGYN, ROCHESTER, NY 14642-1437
(585) 276-5368
Mailing address
601 ELMWOOD AVE DEPT OBGYN, ROCHESTER, NY 14642-0001
(310) 254-7023
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
308289
NY
207V00000X
Obstetrics & Gynecology Physician
50732
MN
363AM0700X
Medical Physician Assistant
308289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
308289
STATTE LICENSE
NY
01
—
50732
STATE LICENSE
MN
01
—
A90758
STATE LICENSE
CA
01
—
MD492147
STATE
PA
Enumeration date
12/28/2006
Last updated
03/24/2026
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