Healthcare Provider Details

I. General information

NPI: 1639263205
Provider Name (Legal Business Name): AMY KEARNEY TOMAINO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVENUE
ROCHESTER NY
14642
US

IV. Provider business mailing address

35 LAKE LACOMA DRIVE
PITTSFORD NY
14534
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-6011
  • Fax: 585-275-3966
Mailing address:
  • Phone: 585-586-0248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number30 300722
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: