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General NPI Number Information
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NPI Number | 1134096175
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Entity Type | Individual
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Provider Name | SOPHIA NICOLE RACANIELLO BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-2559
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SHEPARD ST
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City | ROCHESTER
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State | NY
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Zip | 14620-1818
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Country | US
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Telephone | 585-683-1132
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 819440
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License Number State | NY
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