Provider Demographics
NPI:1659355576
Name:HAHN, CATHY (MD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:HAHN
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 1:174 OAK LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-3136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:59 MONROE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1308
Practice Address - Country:US
Practice Address - Phone:585-385-1710
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231986208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2635OtherEXCELLUS BLS
NY5442307OtherAETNA PROVIDER NUMBER
NY01468648Medicaid
NM101468DLOtherPREFERRED CARE PROVIDER