Healthcare Provider Details

I. General information

NPI: 1285352112
Provider Name (Legal Business Name): RUTH KOHLMEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E HENRIETTA RD
ROCHESTER NY
14623-1406
US

IV. Provider business mailing address

740 E HENRIETTA RD
ROCHESTER NY
14623-1406
US

V. Phone/Fax

Practice location:
  • Phone: 585-753-7905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number278460
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: