Individual
CAITLIN L TILLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
401 S MAIN ST STE 200, CANANDAIGUA, NY 14424-2157
(585) 394-1875
(585) 394-1878
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-1900
(585) 922-0636
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
309029
NY
Other
Enumeration date
03/21/2019
Last updated
03/18/2025
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