Healthcare Provider Details

I. General information

NPI: 1922743723
Provider Name (Legal Business Name): URMILA SIVAGNANALINGAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CELEBRATION DR
ROCHESTER NY
14620-2664
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 278797
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-7546
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number343799
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: