Individual
DR. HEATHER MARIE MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-2654
(585) 275-3271
(585) 442-2949
Mailing address
601 ELMWOOD AVE BOX 664, ROCHESTER, NY 14642-0001
(585) 275-3271
(585) 442-2949
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
293999
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125062858
MEDICAL LICENSE TEMP
IL
Enumeration date
03/22/2013
Last updated
06/30/2023
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