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NPI Code Detail

MEDICARE: LORI ANN GONYO NP

MEDICARE:   LORI ANN GONYO  NP
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
1363LA2200XAdult Health Nurse Practitioner305383NY

General Provider Information

NPI Number : 1871894774
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN GONYO NP
Provider Business Mailing Address
First Line : 416 ALFONSO DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-2058
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4164
Country : US
Telephone Number : 585-723-7870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2010
Last Update Date : 11/15/2023

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