MEDICARE: MELISSA ROSE GORSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	043882	NY

General Provider Information

NPI Number	:	1225633597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ROSE GORSKI

Provider Business Mailing Address
First Line	:	4917 WILLIAM ST # NA
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-3200
Country	:	US
Telephone Number	:	716-473-1300
Fax Number	:	716-395-3005

Provider Business Practice Location Address
First Line	:	4917 WILLIAM ST # NA
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-3200
Country	:	US
Telephone Number	:	716-473-1300
Fax Number	:	716-395-3005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	12/03/2020

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Directions to “ MELISSA ROSE GORSKI ” Practice Location

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