Individual
JOHN T QUEENAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-4065
(585) 756-5717
Mailing address
601 ELMWOOD AVE, BOX 668, ROCHESTER, NY 14642-0001
(585) 275-0638
(585) 273-3359
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
218840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02104745
—
NY
01
—
4935069
AETNA
NY
01
—
MDF691
PREFERRED CARE
NY
01
—
P010218840
BLUE CHOICE
NY
Enumeration date
07/11/2006
Last updated
07/05/2023
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