Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 131660 | NY |
NPI | 1013967074 |
---|---|
Provider Name | Dr. Laura J Von Doenhoff |
First Address | Rochester, NY 14621-3039 |
Second Address | Rochester, NY 14621-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 04/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00616633 | (05) | NY |
0732 | EXCELLUS (01) | NY |
315769 | WELLCARE (01) | NY |
5309317 | AETNA (01) | NY |
B72479 | (02) | NY |
MD4G96 | PREFERRED CARE PIN (01) | NY |
P010131660 | BLUE CHOICE PIN (01) | NY |
RB5158 | MEDICARE PTAN (01) | NY |