Individual
M COLLEEN O'NEIL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-0001
(585) 341-3015
Mailing address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-0001
(585) 341-3015
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
178983
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
178983
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01149155
—
NY
Enumeration date
07/31/2006
Last updated
07/19/2011
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