Healthcare Provider Details

I. General information

NPI: 1982699120
Provider Name (Legal Business Name): JENNIFER CADIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RED CREEK DR PLUTA CANCER CENTER
ROCHESTER NY
14623-4272
US

IV. Provider business mailing address

125 RED CREEK DR PLUTA CANCER CENTER
ROCHESTER NY
14623-4272
US

V. Phone/Fax

Practice location:
  • Phone: 585-486-0600
  • Fax: 585-486-0649
Mailing address:
  • Phone: 585-486-0600
  • Fax: 585-486-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number181041
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: