Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 249194 | NY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 249194 | NY |
NPI | 1063435238 |
---|---|
Provider Name | Dr. Roksolana Kuchma |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14626-4127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/06/2015 |