Individual
DR. DIDEM MIRALOGLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.
Contact information
Practice address
156 WEST AVE, SUITE 106, BROCKPORT, NY 14420-1229
(585) 637-7558
(585) 637-7566
Mailing address
601 ELMWOOD AVE, BOX 278980, ROCHESTER, NY 14642-0001
(585) 637-7558
(585) 637-7566
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
233008
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02649347
—
NY
Enumeration date
01/27/2006
Last updated
07/24/2013
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