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NPI Code Detail

MEDICARE: DR. KIMBERLY ELLEN ERWAY M.D.

MEDICARE: DR. KIMBERLY ELLEN ERWAY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician234732NY
22084P0800XPsychiatry PhysicianS3899TX

General Provider Information

NPI Number : 1649350794
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY ELLEN ERWAY M.D.
Provider Business Mailing Address
First Line : 150 MOUNT HOPE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1016
Country : US
Telephone Number : 585-777-3511
Fax Number :
Provider Business Practice Location Address
First Line : 150 MOUNT HOPE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1016
Country : US
Telephone Number : 585-777-3511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 05/05/2022

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