Healthcare Provider Details

I. General information

NPI: 1003026147
Provider Name (Legal Business Name): ROHINI DILIP THODGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 CENTRAL AVE
DUNKIRK NY
14048-3423
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD SUITE 208
NORTH TONAWANDA NY
14120-2019
US

V. Phone/Fax

Practice location:
  • Phone: 716-366-6036
  • Fax: 716-366-3177
Mailing address:
  • Phone: 716-692-2160
  • Fax: 716-213-0935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number002940
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: