Healthcare Provider Details

I. General information

NPI: 1124211057
Provider Name (Legal Business Name): ESTHER NANCY PRINCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 SENATOR KEATING BLVD BUILDING E SUITE 340
ROCHESTER NY
14618
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 667
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2647
  • Fax: 585-275-0707
Mailing address:
  • Phone: 585-275-2647
  • Fax: 585-275-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number286875
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: