Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 309034 | NY |
NPI | 1386021723 |
---|---|
Provider Name | Andrew Coniglio |
First Address | Rochester, NY 14617-5504 |
Second Address | Rochester, NY 14618-2688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2015 |
Last Update Date | 11/08/2021 |