Individual
ELIOT GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 EMPIRE BLVD, WEBSTER, NY 14580-1957
(585) 922-0930
(585) 787-2533
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
290338
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04919004
—
NY
Enumeration date
07/27/2014
Last updated
03/07/2023
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