Healthcare Provider Details

I. General information

NPI: 1932167046
Provider Name (Legal Business Name): JOHN JOSEPH D'AMORE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 PARRISH ST
CANANDAIGUA NY
14424-1729
US

IV. Provider business mailing address

213 STATE ROUTE 245
RUSHVILLE NY
14544-9604
US

V. Phone/Fax

Practice location:
  • Phone: 585-394-4920
  • Fax: 585-394-9089
Mailing address:
  • Phone: 585-554-3119
  • Fax: 585-554-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: