MEDICARE: MS. IRLANDE ROBILLARD ANP

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	282N00000X	General Acute Care Hospital	556465-1	NY
2	363LA2200X	Adult Health Nurse Practitioner	556465-1	NY

General Provider Information

NPI Number	:	1558515387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRLANDE ROBILLARD ANP

Provider Business Mailing Address
First Line	:	44 LILAC DR APT 4
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-3256
Country	:	US
Telephone Number	:	845-548-7324
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 PORTLAND AVENUE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14621-3095
Country	:	US
Telephone Number	:	585-922-4000
Fax Number	:

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

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	11/06/2008

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