Provider Demographics
NPI:1225056294
Name:ZINKAND, HEIDI (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:ZINKAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214C LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1208
Mailing Address - Country:US
Mailing Address - Phone:585-423-5800
Mailing Address - Fax:585-423-2890
Practice Address - Street 1:322 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1017
Practice Address - Country:US
Practice Address - Phone:585-254-6480
Practice Address - Fax:585-254-1090
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171836207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010171836OtherBLUE CHOICE ROCHESTER
NY101209BFOtherPREFERRED CARE
NY171836Medicaid
NY080053769OtherRAILROAD MCARE
NY6938OtherBLUE CROSS ROCHESTER
NY080053769OtherRAILROAD MCARE
NY10690DMedicare ID - Type UnspecifiedMEDICARE PART B
NYP010171836OtherBLUE CHOICE ROCHESTER