Provider Demographics
NPI:1164510251
Name:DAVIDOFF, TRACEY Q (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:Q
Last Name:DAVIDOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3300 MONROE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-4624
Mailing Address - Country:US
Mailing Address - Phone:585-256-3240
Mailing Address - Fax:585-387-0686
Practice Address - Street 1:3300 MONROE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4624
Practice Address - Country:US
Practice Address - Phone:585-256-3240
Practice Address - Fax:585-387-0686
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY192889207R00000X
FLME135427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine