Individual
MIA ELIZABETH GESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
224 ALEXANDER ST, ROCHESTER, NY 14607-4000
(585) 922-7770
(585) 922-7775
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-7770
(585) 922-7775
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402680
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14479423
CAQH
NY
Enumeration date
07/09/2019
Last updated
07/09/2019
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