Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 301433 | NY |
NPI | 1013029677 |
---|---|
Provider Name | Ms. Sonia Kay Liberatore |
First Address | Pittsford, NY 14534-2621 |
Second Address | Bath, NY 14810-0810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |