Provider Demographics
NPI:1588608541
Name:PRZYSTAL, CATHERINE F (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:F
Last Name:PRZYSTAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 278980
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3350 BROWN RD
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:NY
Practice Address - Zip Code:14423-9534
Practice Address - Country:US
Practice Address - Phone:585-538-6250
Practice Address - Fax:585-538-6223
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217471208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02283356Medicaid
NYH38834Medicare UPIN
NY02283356Medicaid