| Mary Coan | |
|
115 Sullys Trl Ste 4 Pittsford NY 14534-4571 | |
| (315) 462-3553 | |
| (315) 462-3104 |
| Full Name | Mary Coan |
|---|---|
| Speciality | Family Medicine |
| Location | 115 Sullys Trl Ste 4, Pittsford, New York |
| Authorized Official Name and Position | Mary L Coan (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3154623553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Coan 115 Sullys Trl Ste 4 Pittsford NY 14534-4571 Ph: (315) 462-3553 | Mary Coan 115 Sullys Trl Ste 4 Pittsford NY 14534-4571 Ph: (315) 462-3553 |
| NPI Number | 1841594447 |
|---|---|
| Provider Enumeration Date | 12/23/2010 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 7416135801 |
|---|---|
| Medicare Enrollment ID | O20110707000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841594447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 214314 (New York) | Primary |
| Provider Name | Mary L Coan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275560369 PECOS PAC ID: 0648285452 Enrollment ID: I20060215000726 |
| Provider Name | Nathaniel K Hamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699704072 PECOS PAC ID: 5496709933 Enrollment ID: I20171213001486 |
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