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NPI Code Detail

MEDICARE: MAURIANA VANPUTTE

MEDICARE: MAURIANA VANPUTTE
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
1363LF0000XFamily Nurse Practitioner356169NY

General Provider Information

NPI Number : 1639970189
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAURIANA VANPUTTE
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 309 UPPER FALLS BLVD
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2105
Country : US
Telephone Number : 585-922-0260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2025
Last Update Date : 03/21/2025

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Directions to “ MAURIANA VANPUTTE ” Practice Location

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