Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 225935 | NY |
N | 207Q00000X | Family Doctor | 225935 | NY |
NPI | 1104886076 |
---|---|
Provider Name | Dr. Eileen Marie Nugent |
First Address | Rochester, NY 14610-2903 |
Second Address | Pittsford, NY 14534-4566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 09/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H73768 | (02) | NY |