Provider Demographics
NPI:1710508510
Name:RISPOLI, ASHLEY M
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:M
Last Name:RISPOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ABERDEEN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1254
Mailing Address - Country:US
Mailing Address - Phone:585-532-1060
Mailing Address - Fax:
Practice Address - Street 1:91 ABERDEEN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1254
Practice Address - Country:US
Practice Address - Phone:585-532-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336169164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse