Provider Demographics
NPI:1760439632
Name:KOLKIN, SETH (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:KOLKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:601 ELMWOOD AVE BOX 578984
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-1200
Mailing Address - Fax:
Practice Address - Street 1:919 WESTFALL ROAD
Practice Address - Street 2:BLDG C220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2628
Practice Address - Country:US
Practice Address - Phone:585-341-7500
Practice Address - Fax:585-461-9078
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1742442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04663558Medicaid
NY04663558Medicaid
041500OtherBC/BS
NY04663558Medicaid