MEDICARE: SHIRLEY JANE CIRILLO MD

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	2084N0400X	Neurology Physician	238147	NY

General Provider Information

NPI Number	:	1316927007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY JANE CIRILLO MD

Provider Business Mailing Address
First Line	:	1734 RIDGE RD E
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14622-2157
Country	:	US
Telephone Number	:	585-467-8888
Fax Number	:	585-338-1217

Provider Business Practice Location Address
First Line	:	1734 RIDGE RD E
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14622-2157
Country	:	US
Telephone Number	:	585-467-8888
Fax Number	:	585-338-1217

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/11/2024

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