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Individual

DIANE KANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1500 PORTLAND AVENUE, ST ANNS COMMUNITY, ROCHESTER, NY 14621
(585) 697-6413
(585) 342-9166
Mailing address
1500 PORTLAND AVENUE, ST ANNS COMMUNITY, ROCHESTER, NY 14621
(585) 697-6413
(585) 342-9166

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1703411
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
170341-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102536BJ
PREFERRED CARE
01
P010170341
BLUE CHOICE
01
P020170341
BLUE SHIELD ST ANNS
01
P030170341
BLUE SHIELD HERITAGE
01
P040170341
SACMP
Enumeration date
01/03/2006
Last updated
07/06/2015
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