Individual
ANNAMMA ISAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1561 LONG POND RD, SUITE 130, ROCHESTER, NY 14626-4117
(585) 723-7765
(585) 723-7735
Mailing address
1561 LONG POND RD, SUITE 130, ROCHESTER, NY 14626-4117
(585) 723-7765
(585) 723-7735
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
150095
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000527713001
HEALTH NOW
NY
01
—
5099176
GHI
NY
01
—
7386219
AETNA
NY
Enumeration date
06/19/2006
Last updated
07/08/2007
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