Healthcare Provider Details

I. General information

NPI: 1437312956
Provider Name (Legal Business Name): ANA MOLOVIC-KOKOVIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 E RIDGE RD
ROCHESTER NY
14621-1240
US

IV. Provider business mailing address

141 COURTNEY DR
FAIRPORT NY
14450-7065
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-0400
  • Fax: 585-922-0455
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number270458
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number270458
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: