Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 290075 | NY |
NPI | 1003234709 |
---|---|
Provider Name | Amy Bodrog |
First Address | Rochester, NY 14621-3011 |
Second Address | Rochester, NY 14621-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 15/04/2021 |