Healthcare Provider Details

I. General information

NPI: 1861714958
Provider Name (Legal Business Name): MARY BETH GILBERT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HAGEN DR
ROCHESTER NY
14625-2666
US

IV. Provider business mailing address

20 HAGEN DR
ROCHESTER NY
14625-2666
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-9150
  • Fax: 585-922-9732
Mailing address:
  • Phone: 585-922-9150
  • Fax: 585-922-9732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number33315
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: