National Provider Identifier
Jonathan Logan, M.D.
Jonathan Logan, M.D. is listed in the NPPES registry with a primary specialty of Allergy Physician in Canandaigua, NY and a listed phone number of (585) 394-6070.
Profile Overview
- NPI
- 1609871573
- Provider Type
- Individual
- Primary Specialty
- Allergy Physician
- Enumeration Date
- June 16, 2005
- Last Updated
- January 26, 2010
Practice Location
- 201 Parrish St
- Canandaigua, NY 14424-1727
Phone: (585) 394-6070
Specialties
- Allergy Physician (207KA0200X)
Full Record
- NPI
- 1609871573
- Entity Type
- Individual
- Last Name
- Logan
- First Name
- Jonathan
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 201 Parrish St
- Mailing City
- Canandaigua
- Mailing State
- NY
- Mailing ZIP Code
- 14424-1727
- Mailing Country
- US
- Mailing Phone
- (585) 394-6070
- Mailing Fax
- (585) 394-3068
- Practice Street Address
- 201 Parrish St
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-1727
- Practice Country
- US
- Practice Phone
- (585) 394-6070
- Enumeration Date
- June 16, 2005
- Last Updated
- January 26, 2010
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Allergy Physician (207KA0200X)
- Other Identifiers
- P010089546 (NY, Excellus Blue Choice), 1360 (NY, Excellus Blue Shield), 100497AA (NY, Preferred Care Al), 00025452201 (NY, Univera), 030001160 (NY, Railroad Medicare), 100497DT (NY, Preferred Care PA), 5176319 (NY, Aetna)