Individual
AMY Y GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
78 DREXEL DR, ROCHESTER, NY 14606-5333
(585) 426-5184
Mailing address
78 DREXEL DR, ROCHESTER, NY 14606-5333
(585) 426-5184
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
252208-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01977077
—
NY
Enumeration date
05/15/2007
Last updated
07/09/2007
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