MEDICARE: LORALEE SPARACINO N.P.

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
1	363L00000X	Nurse Practitioner	F380596-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346242658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORALEE SPARACINO N.P.

Provider Business Mailing Address
First Line	:	2561 LAC DE VILLE BLVD
Second Line	:	STE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5645
Country	:	US
Telephone Number	:	585-244-3510
Fax Number	:	585-244-3519

Provider Business Practice Location Address
First Line	:	2561 LAC DE VILLE BLVD
Second Line	:	STE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5645
Country	:	US
Telephone Number	:	585-244-3510
Fax Number	:	585-244-3519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/07/2008

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