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Individual

KELITA L FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
158 ORCHARD ST, ROCHESTER, NY 14611-1361
(585) 368-4500
(585) 436-6047
Mailing address
158 ORCHARD ST, ROCHESTER, NY 14611-1361
(585) 368-4500
(585) 436-6047

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
269938
NY
207Q00000X
Family Medicine Physician
4301501395
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03687625
NY
Enumeration date
07/02/2010
Last updated
06/15/2020
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