Provider Demographics
NPI:1447416623
Name:LONDORF, DONALD (MD, LAC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:LONDORF
Suffix:
Gender:M
Credentials:MD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 MONROE AVE STE 333
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5513
Mailing Address - Country:US
Mailing Address - Phone:585-234-0302
Mailing Address - Fax:
Practice Address - Street 1:1 GROVE ST STE 117
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1339
Practice Address - Country:US
Practice Address - Phone:585-234-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA198785-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice