MEDICARE: XIONTE SIMONE DONALSON

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
1	207R00000X	Internal Medicine Physician	029274	NY

General Provider Information

NPI Number	:	1922711357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XIONTE SIMONE DONALSON

Provider Business Mailing Address
First Line	:	120 ERIE CANAL DR STE 300
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4609
Country	:	US
Telephone Number	:	585-865-8210
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 ERIE CANAL DR STE 300
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4609
Country	:	US
Telephone Number	:	585-865-8210
Fax Number	:	585-865-7597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2022
Last Update Date	:	04/26/2026

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Directions to “ XIONTE SIMONE DONALSON ” Practice Location

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