Provider Demographics
NPI:1881652675
Name:AHLMAN, DIANE E (MD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:AHLMAN
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 STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5645
Mailing Address - Country:US
Mailing Address - Phone:585-244-7330
Mailing Address - Fax:585-244-6958
Practice Address - Street 1:2561 LAC DE VILLE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5645
Practice Address - Country:US
Practice Address - Phone:585-244-7330
Practice Address - Fax:585-244-6958
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01852217Medicaid
NY0414024OtherIHA
NY051005000000OtherFIDELIS
NY00027338801OtherUNIVERA
NY101712BJOtherPREFERRED CARE
NY1022OtherSIDNEY HILLMAN
NY051005000000OtherFIDELIS
NY101712BJOtherPREFERRED CARE