Provider Demographics
NPI:1316961683
Name:D'AMORE, KIMBERLY J (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:J
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:198 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1729
Mailing Address - Country:US
Mailing Address - Phone:585-393-1550
Mailing Address - Fax:585-394-9089
Practice Address - Street 1:198 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1729
Practice Address - Country:US
Practice Address - Phone:585-393-1550
Practice Address - Fax:585-394-9089
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY209611208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01868331Medicaid
B18092Medicare UPIN
NY01868331Medicaid