Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 401059 | NY |
NPI | 1033390885 |
---|---|
Provider Name | Mr. William Michael Gassmann |
First Address | Rochester, NY 14620 |
Second Address | Clifton Springs, NY 14432-1122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2007 |
Last Update Date | 30/03/2021 |