| Gavia Lifecare Center, Llc | |
|
1343 Long Pond Rd Ste A Rochester NY 14626-2913 | |
| (585) 371-6464 | |
| (585) 371-6464 |
| Full Name | Gavia Lifecare Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1343 Long Pond Rd Ste A, Rochester, New York |
| Authorized Official Name and Position | Sherry L. Nau (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5853716464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gavia Lifecare Center, Llc 1343 Long Pond Rd Ste A Rochester NY 14626-2913 Ph: (585) 371-6464 | Gavia Lifecare Center, Llc 1343 Long Pond Rd Ste A Rochester NY 14626-2913 Ph: (585) 371-6464 |
| NPI Number | 1710592209 |
|---|---|
| Provider Enumeration Date | 09/10/2020 |
| Last Update Date | 04/22/2021 |
| Certification Date | 04/22/2021 |
| Medicare PECOS PAC ID | 0749697084 |
|---|---|
| Medicare Enrollment ID | O20210427001350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710592209 | NPI | - | NPPES |
| Provider Name | Sherry L Nau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770543910 PECOS PAC ID: 8123026077 Enrollment ID: I20061201000199 |
| Provider Name | Randi N Bisbano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396166575 PECOS PAC ID: 2264654326 Enrollment ID: I20141105002489 |
| Provider Name | Aaron Mascunana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548682032 PECOS PAC ID: 4486086717 Enrollment ID: I20191107000784 |
| Provider Name | Rosemary Shanahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851865380 PECOS PAC ID: 0244630408 Enrollment ID: I20210610000969 |
| Provider Name | Abby E Leaty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972227551 PECOS PAC ID: 3678942109 Enrollment ID: I20240117002308 |
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