Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F400550 | NY |
NPI | 1023138146 |
---|---|
Provider Name | Kathleen S Cardegna |
First Address | Rochester, NY 14611-2335 |
Second Address | Rochester, NY 14611-2335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 15/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P85042 | (02) | NY |