Healthcare Provider Details

I. General information

NPI: 1629455670
Provider Name (Legal Business Name): DIEGO HERNANDEZ-ARANDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 07/22/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 RED CREEK DR STE 120
ROCHESTER NY
14623-4284
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-487-3400
  • Fax: 585-334-3327
Mailing address:
  • Phone: 585-487-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number298194
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number298194
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number298194
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: