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General NPI Number Information
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NPI Number | 1790364131
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Entity Type | Individual
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Provider Name | JANICE M GENNOCRO NP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 3950 E ROBINSON RD STE 109
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City | AMHERST
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State | NY
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Zip | 14228-2042
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Country | US
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Telephone | 716-629-3338
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Fax | 716-304-6571
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Provider Business Mailing Address
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Address Line | 6941 WILLIAMS RD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-3022
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Country | US
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Telephone | 716-629-3338
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Fax | 716-304-6571
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F347137-01
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License Number State | NY
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