Healthcare Provider Details

I. General information

NPI: 1851628655
Provider Name (Legal Business Name): ANDREW SETH DONIGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WESTFALL RD ROOM 952
ROCHESTER NY
14620-4647
US

IV. Provider business mailing address

111 WESTFALL RD ROOM 952
ROCHESTER NY
14620-4647
US

V. Phone/Fax

Practice location:
  • Phone: 585-753-2989
  • Fax: 585-753-5115
Mailing address:
  • Phone: 585-753-2989
  • Fax: 585-753-5115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number152459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: