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NPI Code Detail

MEDICARE: MR. DANA RENE GIGNAC R.PH.

MEDICARE: MR. DANA RENE GIGNAC R.PH.
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
1183500000XPharmacist039902NY

General Provider Information

NPI Number : 1205899903
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANA RENE GIGNAC R.PH.
Provider Business Mailing Address
First Line : 192 LYELL AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14608-1317
Country : US
Telephone Number : 585-458-2326
Fax Number : 585-458-3817
Provider Business Practice Location Address
First Line : 192 LYELL AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14608-1317
Country : US
Telephone Number : 585-458-2326
Fax Number : 585-458-3817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 07/08/2007

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