Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 000617-1 | NY |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 360470-1 | NY |
NPI | 1144217134 |
---|---|
Provider Name | Mary Robin Macintyre |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14621-3038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 19/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000924350001 | HEALTHNOW PROVIDER ID# (01) | NY |
01874840 | (05) | NY |
161568690 | EMPIRE (01) | NY |
161568690 | POMCO PROVIDER ID# (01) | NY |
1899724 | GHI PPO PROVIDER ID# (01) | NY |
7277063 | AETNA PROVIDER ID NUMBER (01) | NY |
P010000617 | BLUE CHOICE (01) | NY |
S27506 | (02) |