Provider Demographics
NPI:1063435238
Name:KUCHMA, ROKSOLANA (MD)
Entity type:Individual
Prefix:DR
First Name:ROKSOLANA
Middle Name:
Last Name:KUCHMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-1469
Mailing Address - Fax:585-922-1399
Practice Address - Street 1:2350 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4127
Practice Address - Country:US
Practice Address - Phone:585-922-2440
Practice Address - Fax:585-663-3293
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY249194207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine