Provider Demographics
NPI:1467489237
Name:GREENWOOD, GAYLINN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:GAYLINN
Middle Name:MARIE
Last Name:GREENWOOD
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 1:2260 LAKE AVENUE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612
Mailing Address - Country:US
Mailing Address - Phone:585-254-1850
Mailing Address - Fax:585-254-0549
Practice Address - Street 1:2260 LAKE AVENUE
Practice Address - Street 2:SUITE 1000
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612
Practice Address - Country:US
Practice Address - Phone:585-254-1850
Practice Address - Fax:585-254-0549
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178123207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
101288BFOtherPREFERRED CARE
7422051OtherAETNA
000911445002OtherHEALTH NOW
1781236WCFPOtherWORKERS COMP
2506964OtherGHI
NY01684968Medicaid
P010178123OtherBLUE SHIELD
P010178123OtherEXCELLUS PLANS
P010178123OtherEXCELLUS PLANS
F05029Medicare UPIN