Brandon Douglas Mustardo, | |
699 S Main St, Canandaigua, NY 14424-2208 | |
(585) 275-2838 | |
Not Available |
Full Name | Brandon Douglas Mustardo |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 699 S Main St, Canandaigua, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023703311 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 671616 (New York) | Secondary |
363LF0000X | Nurse Practitioner - Family | 351989 (New York) | Primary |
Entity Name | University Urology Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952357493 PECOS PAC ID: 4880642537 Enrollment ID: O20050110000246 |
Mailing Address | Practice Location Address |
---|---|
Brandon Douglas Mustardo, 601 Elmwood Ave Box 619-13, Rochester, NY 14642-0001 Ph: (585) 275-6366 | Brandon Douglas Mustardo, 699 S Main St, Canandaigua, NY 14424-2208 Ph: (585) 275-2838 |
Sue E. Staley, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 350 Parrish St, Canandaigua, NY 14424 Phone: 585-396-6071 | |
Mrs. Lucy Zabelle Stoyles, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 400 Fort Hill Ave, Canandaigua, NY 14424 Phone: 585-394-2000 | |
Ms. Virginia P Krebbeks, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 199 Parrish St, Canandaigua, NY 14424 Phone: 585-394-2520 Fax: 585-394-2524 | |
Terri L Dailey, WHNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 335 Parrish St, Canandaigua, NY 14424 Phone: 585-393-2800 Fax: 585-396-9275 | |
Ms. Shawna Ann Hyland, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 699 S Main St, Canandaigua, NY 14424 Phone: 585-275-2838 | |
Callie Vinci, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 Parrish St, Canandaigua, NY 14424 Phone: 585-396-6000 | |
Matthew Scott Mchenry, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3200 West St Ste 500, Canandaigua, NY 14424 Phone: 585-905-0061 Fax: 585-412-6612 |