Individual
USA CAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3011
(585) 922-4000
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-1318
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
302088
NY
2085R0202X
Diagnostic Radiology Physician
4301119336
MI
Other
Enumeration date
04/28/2014
Last updated
08/07/2020
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