Healthcare Provider Details

I. General information

NPI: 1285045625
Provider Name (Legal Business Name): MICHELE MARCHIOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE MARCHIOLI ANP

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 07/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N MAIN ST
WARSAW NY
14569-1025
US

IV. Provider business mailing address

400 RED CREEK DR STE 220
ROCHESTER NY
14623-4281
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-2233
  • Fax:
Mailing address:
  • Phone: 585-487-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number405638-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF306523-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: