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1174875082
FANTAZIA M EDICK
ROCHESTER, NY
NPI
1174875082
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 10-311923)
Enumeration Date
2012-10-03
Last Update Date
2012-10-03
Business Address
-- FANTAZIA M EDICK LPN
614 CLAY AVE 2
ROCHESTER, NY 14613-1030
Phone number: 585-478-0048
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Mailing Address
-- FANTAZIA M EDICK LPN
614 CLAY AVE 2
ROCHESTER, NY 14613-1030
Phone number: 585-478-0048
Copy
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