Provider Demographics
NPI:1013984814
Name:DAVID M TINKELMAN MD PC
Entity Type:Organization
Organization Name:DAVID M TINKELMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:TINKELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-637-0060
Mailing Address - Street 1:6 SWEDEN LN
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2516
Mailing Address - Country:US
Mailing Address - Phone:585-637-0060
Mailing Address - Fax:585-637-2941
Practice Address - Street 1:6 SWEDEN LN
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2516
Practice Address - Country:US
Practice Address - Phone:585-637-0060
Practice Address - Fax:585-637-2941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP020133341OtherBLUE SHIELD ROCHESTER
NY00507488Medicaid
NYP010133341OtherBLUE CHOICE
NY201002460OtherCHAMPUS
NY2600363OtherGHI
NY000529464002OtherBLUE SHIELD OF WNY
NYP010133341OtherCHILD HEALTH PLUS
NYEXCELLLUSOtherP020133341
NYMD134NOtherPREFERRED CARE
NYP010133341OtherBLUE CHOICE