Provider Demographics
NPI:1083661078
Name:WOOL-COTTONE, JENNIFER (DPM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:WOOL-COTTONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-2728
Mailing Address - Country:US
Mailing Address - Phone:585-342-8700
Mailing Address - Fax:585-342-4951
Practice Address - Street 1:1255 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2728
Practice Address - Country:US
Practice Address - Phone:585-342-8700
Practice Address - Fax:585-342-4951
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005862-2213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY480034847OtherRAILROAD MEDICARE
NYP010115862OtherBLUE SHIELD
NY7301343OtherAETNA
NY9739813OtherGHI
NYP010115862OtherBLUE CHOICE
NY110484EQOtherPREFERRED CARE
NYPO5862OtherWORKERS COMPENSATION
NYP010115862OtherBLUE CHOICE
NYU92620Medicare UPIN