Healthcare Provider Details

I. General information

NPI: 1295373306
Provider Name (Legal Business Name): GAZALI CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 NORTH ST
ROCHESTER NY
14605-2539
US

IV. Provider business mailing address

114 BIRR ST
ROCHESTER NY
14613-1736
US

V. Phone/Fax

Practice location:
  • Phone: 585-507-0312
  • Fax: 585-287-5529
Mailing address:
  • Phone: 585-507-0312
  • Fax: 585-287-5529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MOHAMED GAZALI
Title or Position: CEO/OWNER
Credential:
Phone: 585-507-0312