Provider Demographics
NPI:1588867279
Name:SCIORTINO, CRISTIN A
Entity type:Individual
Prefix:
First Name:CRISTIN
Middle Name:A
Last Name:SCIORTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 W BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9326
Mailing Address - Country:US
Mailing Address - Phone:585-624-3145
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 638
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14472
Practice Address - Country:US
Practice Address - Phone:585-275-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist