Individual
DR. TRACEY DEMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 SOUTH AVE, ROCHESTER, NY 14620-2733
(585) 341-6880
Mailing address
601 ELMWOOD AVE, BOX 655, ROCHESTER, NY 14642-8655
(585) 341-3015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207590
NY
207P00000X
Emergency Medicine Physician
ME94690
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01856606
—
NY
Enumeration date
07/21/2006
Last updated
05/24/2011
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