Provider Demographics
NPI:1447217450
Name:ROCHESTER GYNECOLOGIC AND OBSTETRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ROCHESTER GYNECOLOGIC AND OBSTETRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-467-5940
Mailing Address - Street 1:125 LATTIMORE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4159
Mailing Address - Country:US
Mailing Address - Phone:585-461-5940
Mailing Address - Fax:
Practice Address - Street 1:125 LATTIMORE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4159
Practice Address - Country:US
Practice Address - Phone:585-461-5940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEIN
NY16413AMedicare PIN