Healthcare Provider Details

I. General information

NPI: 1578321410
Provider Name (Legal Business Name): LILIANA GENEVIEVE ZUCARO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 SPRING MEADOW LN
WEBSTER NY
14580-4043
US

IV. Provider business mailing address

533 SPRING MEADOW LN
WEBSTER NY
14580-4043
US

V. Phone/Fax

Practice location:
  • Phone: 585-200-2299
  • Fax:
Mailing address:
  • Phone: 585-200-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number028146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: