MEDICARE: MRS. JESSICA CELENTO R.N.

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	163W00000X	Registered Nurse	22517074	NY

General Provider Information

NPI Number	:	1649671728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA CELENTO R.N.

Provider Business Mailing Address
First Line	:	5 JENNIE CIR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5811
Country	:	US
Telephone Number	:	585-413-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 JENNIE CIR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-5811
Country	:	US
Telephone Number	:	585-413-0021
Fax Number	:

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

Provider Enumeration Date	:	09/09/2014
Last Update Date	:	09/09/2014

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