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General NPI Number Information
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NPI Number | 1093757452
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Entity Type | Organization
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Legal Business Name | FINGERLAKES WOMEN'S HEALTH
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 90 OFFICE PARK WAY
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City | PITTSFORD
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State | NY
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Zip | 14534-1749
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Country | US
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Telephone | 585-586-3640
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Fax | 585-586-3796
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Provider Business Mailing Address
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Address Line | 90 OFFICE PARK WAY
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City | PITTSFORD
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State | NY
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Zip | 14534-1749
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Country | US
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Telephone | 585-586-3640
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Fax | 585-586-3796
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SUSAN E DANTONI
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Credential | MD
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Telephone | 585-586-3640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 207593
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License Number State | NY
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