Healthcare Provider Details

I. General information

NPI: 1912818857
Provider Name (Legal Business Name): LORAINE MARIE MONTANEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 PORTLAND AVE BLDG 3
ROCHESTER NY
14621-3095
US

IV. Provider business mailing address

16 CANDLEWOOD CIR
PITTSFORD NY
14534-4603
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-4000
  • Fax:
Mailing address:
  • Phone: 585-406-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF433312-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: