National Provider Identifier

Kenneth H. Davidson, MD, PC

Kenneth H. Davidson, MD, PC is listed in the NPPES registry with a primary specialty of Cardiovascular Disease Physician in Rochester, NY and a listed phone number of (585) 426-9278.

NPI 1457547184Rochester, NYCardiovascular Disease Physician

Profile Overview

NPI
1457547184
Provider Type
Organization
Primary Specialty
Cardiovascular Disease Physician
Enumeration Date
September 17, 2007
Last Updated
October 09, 2013

Practice Location

  • 1415 Portland Ave
  • Suite 350
  • Rochester, NY 14621-3038

Phone: (585) 426-9278

Specialties

  • Cardiovascular Disease Physician (207RC0000X)
Full Record
NPI
1457547184
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Kenneth H. Davidson, MD, PC
Mailing Street Address
1415 Portland Ave
Mailing Address Line 2
Suite 350
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14621-3038
Mailing Country
US
Mailing Phone
(585) 426-9278
Mailing Fax
(585) 338-2738
Practice Street Address
1415 Portland Ave
Practice Address Line 2
Suite 350
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3038
Practice Country
US
Practice Phone
(585) 426-9278
Practice Fax
(585) 338-2738
Enumeration Date
September 17, 2007
Last Updated
October 09, 2013
Authorized Official Last Name
Davidson
Authorized Official First Name
Kenneth
Authorized Official Title
President
Authorized Official Phone
(585) 426-9278
Organization Subpart
No
Authorized Official Name Prefix Text
Dr.
Authorized Official Credential Text
MD
Taxonomy Group 1
193400000X Single Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Cardiovascular Disease Physician (207RC0000X)
Other Identifiers
Y019296 (Champus), 00450853 (NY), 10453 (Ghi), 4273339 (Aetna), 9913 (Blue Cross Blue Shield), PO10103663 (Blue Choice - Excellus), 005002871 (Blue Shield Western Ny), 005002871 (Community Blue), 07341 (Choice Care), MD4426 (Preferred Care)