Provider Demographics
NPI:1093757452
Name:FINGERLAKES WOMEN'S HEALTH
Entity Type:Organization
Organization Name:FINGERLAKES WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DANTONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-586-3640
Mailing Address - Street 1:90 OFFICE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1749
Mailing Address - Country:US
Mailing Address - Phone:585-586-3640
Mailing Address - Fax:585-586-3796
Practice Address - Street 1:90 OFFICE PARK WAY
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1749
Practice Address - Country:US
Practice Address - Phone:585-586-3640
Practice Address - Fax:585-586-3796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207593207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H09308Medicare UPIN