Individual
MAUREEN C TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1415 PORTLAND AVE STE 220, ROCHESTER, NY 14621-3039
(585) 922-4496
(585) 922-4442
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-4496
(585) 922-4442
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306484
NY
Other
Enumeration date
06/14/2013
Last updated
02/14/2022
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