Provider Demographics
NPI:1518428788
Name:ESCOBAR, JOSEPH GABRIEL (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GABRIEL
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2035
Mailing Address - Country:US
Mailing Address - Phone:585-851-9276
Mailing Address - Fax:
Practice Address - Street 1:838 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-4041
Practice Address - Country:US
Practice Address - Phone:607-742-2635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY677747163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics