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NPI Code Detail

MEDICARE: KATHLEEN A SUGRUE CNM, NP

MEDICARE: KATHLEEN A SUGRUE CNM, NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife001785NY
2363LW0102XWomen's Health Nurse Practitioner421315NY

General Provider Information

NPI Number : 1013426808
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN A SUGRUE CNM, NP
Provider Business Mailing Address
First Line : 300 RED CREEK DR STE 100
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-4283
Country : US
Telephone Number : 585-922-1900
Fax Number : 585-922-0636
Provider Business Practice Location Address
First Line : 50 MIDDLE RD
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9312
Country : US
Telephone Number : 585-235-4860
Fax Number : 585-464-9047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2017
Last Update Date : 12/30/2025

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