Provider Demographics
NPI:1184687188
Name:TOMANI, MADONNA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:ROSE
Last Name:TOMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1882 WINTON RD S
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3950
Mailing Address - Country:US
Mailing Address - Phone:585-698-7077
Mailing Address - Fax:585-461-4105
Practice Address - Street 1:1882 SOUTH WINTON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-698-7077
Practice Address - Fax:585-461-4105
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207415207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000911614005OtherBC/BS OF WESTERN NEW YORK
NY102936CKOtherPREFERRED CARE
NYP010207415OtherBLUE CHOICE
NY000911614003OtherBC/BS OF WESTERN NEW YORK
NYP020207415OtherBC/BS
NY000911614004OtherBC/BS OF WESTERN NEW YORK
NY0296922OtherGHI
NY7808020OtherAETNA
NY01823716Medicaid
NY160058994OtherRAILROAD
NY160058994OtherRAILROAD
NYDD5166Medicare ID - Type Unspecified