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NPI Code Detail

MEDICARE: TERESA GANGAROSSA R.N.

MEDICARE:   TERESA  GANGAROSSA  R.N.
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
1163W00000XRegistered Nurse514639NY

General Provider Information

NPI Number : 1780079202
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA GANGAROSSA R.N.
Provider Business Mailing Address
First Line : 1900 CLINTON AVE S
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-5621
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1900 CLINTON AVE S
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-5621
Country : US
Telephone Number : 585-271-6960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2015
Last Update Date : 04/01/2015

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Directions to “ TERESA GANGAROSSA R.N.” Practice Location

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