Provider Demographics
NPI:1194755199
Name:BUCHSBAUM, GUNHILDE M (MD)
Entity type:Individual
Prefix:
First Name:GUNHILDE
Middle Name:M
Last Name:BUCHSBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-0638
Mailing Address - Fax:585-273-3359
Practice Address - Street 1:500 RED CREEK DR
Practice Address - Street 2:STE 120
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4284
Practice Address - Country:US
Practice Address - Phone:585-256-3887
Practice Address - Fax:585-256-3508
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192376207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01442608Medicaid
NYMDF068OtherPREFERRED CARE
NYP010192376OtherBLUE SHIELD OF ROCHESTER
NY5286679OtherAETNA
NYP010192376OtherBLUE CHOICE
NYP010192376OtherBLUE SHIELD OF ROCHESTER
NY5286679OtherAETNA
NY01442608Medicaid
NYJ400001874Medicare PIN