Healthcare Provider Details

I. General information

NPI: 1578840963
Provider Name (Legal Business Name): JANE ELIZABETH GIAMBRONE CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 RIDGEWAY AVE SUITE 220
ROCHESTER NY
14626-4296
US

IV. Provider business mailing address

2655 RIDGEWAY AVE SUITE 220
ROCHESTER NY
14626-4296
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-4560
  • Fax: 585-368-4565
Mailing address:
  • Phone: 585-368-4560
  • Fax: 585-368-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number426026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: