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General NPI Number Information
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NPI Number | 1720381171
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Entity Type | Individual
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Provider Name | CARLA D LIOTTA L.P.N.
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Gender | Female
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 190 LONGRIDGE AVE
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City | ROCHESTER
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State | NY
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Zip | 14616-3552
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Country | US
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Telephone | 585-966-5805
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Fax | 585-581-8105
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Provider Business Mailing Address
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Address Line | 828 HAMLIN PARMA TOWNLINE RD
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City | HILTON
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State | NY
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Zip | 14468-9737
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Country | US
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Telephone | 585-392-2524
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 240422-1
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License Number State | NY
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