Individual
MS. CARLISE E GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-4517
(585) 442-9201
Mailing address
601 ELMWOOD AVE, BOX MED, ROCHESTER, NY 14642-0001
(585) 275-4517
(585) 442-9201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
334124
NY
363LF0000X
Family Nurse Practitioner
Primary
3341241
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02777122
—
NY
01
—
P00838557
MEDICARE RAILROAD
NY
Enumeration date
07/31/2008
Last updated
05/15/2023
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