Healthcare Provider Details

I. General information

NPI: 1659310522
Provider Name (Legal Business Name): KARA LEE EASTWOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 RIDGEWAY AVE SUITE 180
ROCHESTER NY
14626-4296
US

IV. Provider business mailing address

2655 RIDGEWAY AVE SUITE 180
ROCHESTER NY
14626-4296
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-4000
  • Fax: 585-225-2685
Mailing address:
  • Phone: 585-368-4000
  • Fax: 585-225-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number240373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: