Provider Demographics
NPI:1285045625
Name:MARCHIOLI, MICHELE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MARCHIOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:MARCHIOLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP
Mailing Address - Street 1:400 RED CREEK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4281
Mailing Address - Country:US
Mailing Address - Phone:585-487-1000
Mailing Address - Fax:
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1025
Practice Address - Country:US
Practice Address - Phone:585-786-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405638-1163W00000X
NYF306523-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse