Individual
TERESA HIWALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 STANFORD WAY, FAIRPORT, NY 14450-9000
(585) 364-1465
Mailing address
6 STANFORD WAY, FAIRPORT, NY 14450
(585) 364-1465
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
425793-1
NY
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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