Individual
DIEGO A GRISALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
259 MONROE AVE, ROCHESTER, NY 14607-3632
(585) 545-7200
Mailing address
259 MONROE AVE, ROCHESTER, NY 14607-3632
(585) 545-7200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
337329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03504529
—
NY
Enumeration date
07/31/2012
Last updated
06/29/2023
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