Healthcare Provider Details

I. General information

NPI: 1063477404
Provider Name (Legal Business Name): MARC H EIGG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/03/2023
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1682 EMPIRE BLVD
WEBSTER NY
14580
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 668
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-671-6790
  • Fax: 585-671-1931
Mailing address:
  • Phone: 585-671-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number192743-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number192743
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number192743-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: