Individual
GINEL CHONTAIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 723-7870
(585) 723-7871
Mailing address
111 LAFAYETTE RD APT 207, SYRACUSE, NY 13205-2901
(516) 424-8646
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
343029
NY
Other
Enumeration date
06/07/2018
Last updated
12/04/2019
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