Healthcare Provider Details

I. General information

NPI: 1376781112
Provider Name (Legal Business Name): CALLIE ROSINA TOOMBS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 02/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SANFORD ST
ROCHESTER NY
14620-2208
US

IV. Provider business mailing address

121 SANFORD ST
ROCHESTER NY
14620-2208
US

V. Phone/Fax

Practice location:
  • Phone: 802-233-6570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number562264
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: