Provider Demographics
NPI:1679531982
Name:PAGE, STEPHANIE LINIGER (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LINIGER
Last Name:PAGE
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 1:2561 LAC DE VILLE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-473-3900
Mailing Address - Fax:585-461-2216
Practice Address - Street 1:2561 LAC DE VILLE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-473-3900
Practice Address - Fax:585-461-2216
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01685065Medicaid
NY051004000079OtherFIDELIS CARE
NYP010184300OtherBLUE CHOICE
NY01685065Medicaid
NY101362DLOtherPREFERRED CARE
NY1213855OtherINDEPENDENT HEALTH