MEDICARE: DR. GREGORY GOTIE

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	183500000X	Pharmacist	054552	NY

General Provider Information

NPI Number	:	1619281458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY GOTIE

Provider Business Mailing Address
First Line	:	3127 CHILI AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-4530
Country	:	US
Telephone Number	:	585-426-7307
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 CHILI AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-4530
Country	:	US
Telephone Number	:	585-426-7307
Fax Number	:

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

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	12/04/2013

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Directions to “ DR. GREGORY GOTIE ” Practice Location

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