Provider Demographics
NPI:1588180087
Name:CIRIGLIANO, SHELBY J (PA-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:J
Last Name:CIRIGLIANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:J
Other - Last Name:CIRIGLIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2561 LAC DE VILLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5645
Mailing Address - Country:US
Mailing Address - Phone:585-424-3410
Mailing Address - Fax:585-214-0042
Practice Address - Street 1:2561 LAC DE VILLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5645
Practice Address - Country:US
Practice Address - Phone:585-424-3410
Practice Address - Fax:585-214-0042
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021156363A00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant