Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 050203 | NY |
Y | 213EG0000X | General Practice | 050203 | NY |
NPI | 1003911553 |
---|---|
Provider Name | Dorota Kopycka-Kedzierawski |
First Address | Rochester, NY 14620-2913 |
Second Address | Rochester, NY 14620-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |