National Provider Identifier
Kerry Widdersheim Graff, M.D.
Kerry Widdersheim Graff, M.D. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Canandaigua, NY and a listed phone number of (585) 394-1875.
Profile Overview
- NPI
- 1700827375
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- June 08, 2006
- Last Updated
- October 18, 2022
Practice Location
- 502 S Main St
- Lake Country Family Medicine
- Canandaigua, NY 14424-2242
Phone: (585) 394-1875
Specialties
- Family Medicine Physician (207Q00000X)
- Public Health & General Preventive Medicine Physician (2083P0901X)
Endpoints
- kerry.graff@rochesterregional.org
Direct Messaging Address | Canandaigua, NY 14424
Full Record
- NPI
- 1700827375
- Entity Type
- Individual
- Last Name
- Graff
- First Name
- Kerry
- Middle Name
- Widdersheim
- Credential
- M.D.
- Provider Other Last Name
- Widdersheim
- Provider Other First Name
- Kerry
- Provider Other Middle Name
- Paige
- Provider Other Credential Text
- M.D.
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 502 S Main St
- Mailing Address Line 2
- Lake Country Family Medicine
- Mailing City
- Canandaigua
- Mailing State
- NY
- Mailing ZIP Code
- 14424-2242
- Mailing Country
- US
- Mailing Phone
- (585) 394-1875
- Mailing Fax
- (888) 990-2283
- Practice Street Address
- 502 S Main St
- Practice Address Line 2
- Lake Country Family Medicine
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-2242
- Practice Country
- US
- Practice Phone
- (585) 394-1875
- Practice Fax
- (888) 990-2283
- Enumeration Date
- June 08, 2006
- Last Updated
- October 18, 2022
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- October 18, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X), Public Health & General Preventive Medicine Physician (2083P0901X)
- Other Identifiers
- 000921058001 (NY, Healthnow), 0520 (NY, Blueshield), 02048819 (NY), P010207638 (NY, Excellus Bc/Bs And Chp), 101717BF (NY, Preferred Care)