Healthcare Provider Details

I. General information

NPI: 1467360164
Provider Name (Legal Business Name): NICHOLE M SANTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MOUNT HOPE AVE
ROCHESTER NY
14620-1016
US

IV. Provider business mailing address

75 E MANITOU RD
ROCHESTER NY
14612-1033
US

V. Phone/Fax

Practice location:
  • Phone: 585-287-5626
  • Fax:
Mailing address:
  • Phone: 585-500-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number5250256
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number327273
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: