Individual
GLORIA JANICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6075 JUDD RD, ORISKANY, NY 13424-4218
(315) 765-2256
Mailing address
6075 JUDD RD, ORISKANY, NY 13424-4218
(315) 732-0594
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302349-1
NY
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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