Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 056700 | NY |
NPI | 1053510776 |
---|---|
Provider Name | Dr. Cristina Gabriela Ciornei |
First Address | Rochester, NY 14620-3405 |
Second Address | Rochester, NY 14620-3405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 20/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056700 | DENTAL LICENSE (01) | NY |