Individual
CATHERINE FANTAUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1342 EMERSON ST, UNIT D, ROCHESTER, NY 14606-3054
(585) 314-3438
Mailing address
1342 EMERSON ST, UNIT D, ROCHESTER, NY 14606-3054
(585) 314-3433
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
236691-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02395917
—
NY
Enumeration date
07/07/2007
Last updated
01/27/2011
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