Provider Demographics
NPI:1477865178
Name:ZOZOBRADO, KAYE PAMELA YEE (MD)
Entity Type:Individual
Prefix:
First Name:KAYE PAMELA
Middle Name:YEE
Last Name:ZOZOBRADO
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 1:2655 RIDGEWAY AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4296
Mailing Address - Country:US
Mailing Address - Phone:585-368-4560
Mailing Address - Fax:585-368-4565
Practice Address - Street 1:2655 RIDGEWAY AVE STE 220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-368-4560
Practice Address - Fax:585-368-4565
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270494207RE0101X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03591393Medicaid
NY01131126/RGHMedicaid
NY03007063/NWKMedicaid
NY01131126/RGHMedicaid
NYJ400090911 NWKMedicare PIN
NY03591393Medicaid
NY70005A/RGHMedicare PIN