Healthcare Provider Details

I. General information

NPI: 1639758386
Provider Name (Legal Business Name): SEAN CIGNARALE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ISLAND COTTAGE RD
ROCHESTER NY
14612-2312
US

IV. Provider business mailing address

33 PRESTWICK LN
CHURCHVILLE NY
14428-9640
US

V. Phone/Fax

Practice location:
  • Phone: 585-368-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: