Individual
CRISSA CAROLYN BLANKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
107 N CLINTON AVE, ROCHESTER, NY 14604-1411
(585) 324-3100
Mailing address
134 ARROWHEAD DR, ROCHESTER, NY 14624-2804
(585) 730-0693
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
315182
NY
Other
Enumeration date
11/13/2018
Last updated
11/13/2018
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