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NPI Code Detail

MEDICARE: AMPARO G TAN RN

MEDICARE: AMPARO G TAN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse579638NY

General Provider Information

NPI Number : 1184868606
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMPARO G TAN RN
Provider Business Mailing Address
First Line : 30 WOOLACOTT RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5117
Country : US
Telephone Number : 585-467-6242
Fax Number :
Provider Business Practice Location Address
First Line : 30 WOOLACOTT RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5117
Country : US
Telephone Number : 585-467-6242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 04/28/2009

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