Healthcare Provider Details

I. General information

NPI: 1164535746
Provider Name (Legal Business Name): GABRIEL J STENZIANO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX MED
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-4517
  • Fax: 585-442-9201
Mailing address:
  • Phone: 585-275-4517
  • Fax: 585-442-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF300819-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: