Provider Demographics
NPI:1346270626
Name:MOLINARI, DIANE (DO)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:MOLINARI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 LONG POND RD
Mailing Address - Street 2:EMERGENCY CENTER PARK RIDGE HOSPITAL
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4122
Mailing Address - Country:US
Mailing Address - Phone:585-723-7070
Mailing Address - Fax:585-723-7045
Practice Address - Street 1:1555 LONG POND RD
Practice Address - Street 2:EMERGENCY CENTER PARK RIDGE HOSPITAL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4122
Practice Address - Country:US
Practice Address - Phone:585-723-7070
Practice Address - Fax:585-723-7045
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191609207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01407749Medicaid
NY191609-7WOtherWORKERS' COMPENSATION
NY191609-7WOtherWORKERS' COMPENSATION
NY01407749Medicaid
NY191609-7WOtherWORKERS' COMPENSATION
F53986Medicare UPIN
NY4798518OtherGHI