MEDICARE: JULIA SHIRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	433540	NY

General Provider Information

NPI Number	:	1063377026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA SHIRE

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE.
Second Line	:	BOX 679-B
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:	585-275-2975
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:	585-275-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	03/23/2026

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Directions to “ JULIA SHIRE ” Practice Location

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