Healthcare Provider Details

I. General information

NPI: 1003711276
Provider Name (Legal Business Name): MARYANN GUNTHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 CHESTNUT DR
ROCHESTER NY
14624-4027
US

IV. Provider business mailing address

80 CHESTNUT DR
ROCHESTER NY
14624-4027
US

V. Phone/Fax

Practice location:
  • Phone: 585-478-4731
  • Fax: 585-625-0106
Mailing address:
  • Phone: 585-478-4731
  • Fax: 585-625-0106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: