Individual
GENEVA MODRAK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10 HAGEN DR, ROCHESTER, NY 14625-2660
(585) 367-8200
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 449-0513
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
419342
NY
Other
Enumeration date
05/26/2006
Last updated
07/05/2023
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