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NPI Code Detail

MEDICARE: DAISHA MARIE VAZQUEZ

MEDICARE: DAISHA MARIE VAZQUEZ
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
1171M00000XCase Manager/Care CoordinatorNY

General Provider Information

NPI Number : 1740136563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISHA MARIE VAZQUEZ
Provider Business Mailing Address
First Line : 3300 DEWEY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-3741
Country : US
Telephone Number : 585-865-1550
Fax Number :
Provider Business Practice Location Address
First Line : 3300 DEWEY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-3741
Country : US
Telephone Number : 585-865-1550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2026
Last Update Date : 03/05/2026

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Directions to “ DAISHA MARIE VAZQUEZ ” Practice Location

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