Healthcare Provider Details

I. General information

NPI: 1801243027
Provider Name (Legal Business Name): TAYLOR DAMATO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 MILLENNIUM DR
GENESEO NY
14454-1197
US

IV. Provider business mailing address

4612 MILLENNIUM DR
GENESEO NY
14454-1197
US

V. Phone/Fax

Practice location:
  • Phone: 585-443-2018
  • Fax:
Mailing address:
  • Phone: 585-443-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN682250
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number405579
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number692070
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: