Healthcare Provider Details

I. General information

NPI: 1568882249
Provider Name (Legal Business Name): CHERIE ZICARI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 PORTLAND AVE STE 108
ROCHESTER NY
14621
US

IV. Provider business mailing address

100 KINGS HWY S
ROCHESTER NY
14617-5504
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-5550
  • Fax: 585-922-5950
Mailing address:
  • Phone: 585-922-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338457
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number338457
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: