Provider Demographics
NPI:1902009954
Name:ODROBINA, MICHELE R (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:ODROBINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11225 MAPLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-1845
Mailing Address - Country:US
Mailing Address - Phone:585-798-2865
Mailing Address - Fax:585-798-2867
Practice Address - Street 1:11225 MAPLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1845
Practice Address - Country:US
Practice Address - Phone:585-798-2865
Practice Address - Fax:585-798-2867
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243920-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1609873520OtherMEDICARE GROUP NPI
NY00028118501OtherUNIVERA
NY000529330001OtherBCBS OF WNY
NYP20243920OtherBLUE CHOICE
NY02892588Medicaid
NYP010243920OtherMUNROE PLAN
NY0714265OtherINDEPENDANT HEALTH
NY1902009954OtherMEDICARE INDIVIDUAL NPI
NY204676CKOtherPREFERRED CARE
NY204676CKOtherPREFERRED CARE