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Keanu Tyler Vaccaro
Licensed Practical Nurse in Rochester, New York
NPI 1285277319

Keanu Tyler Vaccaro is a Licensed Practical Nurse based in Rochester, NY. Keanu Tyler Vaccaro practices in Rochester, NY. The NPI Number for Keanu Tyler Vaccaro is 1285277319 and holds a License No. 312825 (New York).

The current practice location address for Keanu Tyler Vaccaro is 40 Midland Ave, Rochester, NY and can be reached out via phone at 719-574-9115.

Location: 40 Midland Ave, Rochester, NY, 14621-4050
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285277319
Provider Name
Keanu Tyler Vaccaro
Credential
Provider Entity Type
Individual
Gender
Male
Address
40 Midland Ave, Rochester, NY, 14621-4050
Phone Number
719-574-9115
Fax Number
Provider Enumeration Date
10/22/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
40 Midland Ave
City
Rochester
State
New York
Zip
14621-4050
Phone Number
719-574-9115
Fax Number
person
Provider Business Mailing Address Details
Address
40 Midland Ave
City
Rochester
State
New York
Zip
14621-4050
Phone Number
719-574-9115
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
312825 (New York)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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