Provider Demographics
NPI:1417168626
Name:KRANZ, PEBBLE M (MD)
Entity Type:Individual
Prefix:DR
First Name:PEBBLE
Middle Name:M
Last Name:KRANZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:29 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2927
Mailing Address - Country:US
Mailing Address - Phone:585-355-5708
Mailing Address - Fax:844-765-5645
Practice Address - Street 1:625 PANORAMA TRL STE 2220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2431
Practice Address - Country:US
Practice Address - Phone:585-865-3584
Practice Address - Fax:844-765-5645
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY257853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program