Provider Demographics
NPI:1770552341
Name:MORSE, DIANE S (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:S
Last Name:MORSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX: PSYCH
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-279-4999
Mailing Address - Fax:585-276-0161
Practice Address - Street 1:2613 W HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2327
Practice Address - Country:US
Practice Address - Phone:585-279-4999
Practice Address - Fax:585-473-5152
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY181763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01563753Medicaid
NYF69646Medicare UPIN
NYJ400000265Medicare PIN
NYDD2486Medicare ID - Type Unspecified
NY01563753Medicaid