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Individual

DR. MARIA G MASTROSIMONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1441 EAST AVE, SUITE 107-2, ROCHESTER, NY 14610-1665
(585) 234-4081
Mailing address
249 HIGHLAND PARKWAY, ROCHESTER, NY 14620
(585) 461-5091

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
196380
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01728409
NY
01
J400000981
MEDICARE PTAN
NY
01
P010196380
EXCELLUS PLANS
Enumeration date
05/20/2006
Last updated
12/29/2008
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