Healthcare Provider Details

I. General information

NPI: 1992236905
Provider Name (Legal Business Name): NOEL YARZE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 07/07/2023
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 SOUTH AVE STE 207
ROCHESTER NY
14620-2762
US

IV. Provider business mailing address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6660
  • Fax: 585-341-8310
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number309924
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number309924
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: