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Individual

KERRY WIDDERSHEIM GRAFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
502 S MAIN ST, LAKE COUNTRY FAMILY MEDICINE, CANANDAIGUA, NY 14424-2242
(585) 394-1875
(888) 990-2283
Mailing address
502 S MAIN ST, LAKE COUNTRY FAMILY MEDICINE, CANANDAIGUA, NY 14424-2242
(585) 394-1875
(888) 990-2283

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207638
NY
2083P0901X
Public Health & General Preventive Medicine Physician
207638
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000921058001
HEALTHNOW
NY
05
02048819
NY
01
0520
BLUESHIELD
NY
01
101717BF
PREFERRED CARE
NY
01
P010207638
EXCELLUS BC/BS AND CHP
NY
Enumeration date
06/08/2006
Last updated
10/18/2022
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