Basic Information
| Provider Information | |||||||||
| NPI: | 1134197387 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUAIDOO | ||||||||
| FirstName: | EMMANUEL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 HAGEN DR STE 330 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146252661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859228350 | ||||||||
| FaxNumber: | 5859228355 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 MERIDIAN CENTRE BLVD | ||||||||
| Address2: | STE 300 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146183984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854420150 | ||||||||
| FaxNumber: | 5852718704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 07/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 193211 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207K00000X | 193211 | NY | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.