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General NPI Number Information
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NPI Number | 1952348575
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Entity Type | Individual
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Provider Name | GISSOU AZABDAFTARI MD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 8 SABLE CT W
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City | EAST AMHERST
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State | NY
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Zip | 14051-2210
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Country | US
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Telephone | 716-845-2300
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Fax | 716-845-3427
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVENUE BOX 626
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-5656
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Fax | 585-276-2024
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 256980
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 256980
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License Number State | NY
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