Healthcare Provider Details

I. General information

NPI: 1295421220
Provider Name (Legal Business Name): HIYAM ALI DAUD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 PORTLAND AVE
ROCHESTER NY
14621-3011
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-338-1400
  • Fax: 585-338-4925
Mailing address:
  • Phone: 585-922-1970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number345424
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: