Provider Demographics
NPI:1144588138
Name:ALBANESE, RICK (LPN)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:ALBANESE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:3668 RETSOF
Mailing Address - City:RETSOF
Mailing Address - State:NY
Mailing Address - Zip Code:14539-0300
Mailing Address - Country:US
Mailing Address - Phone:585-245-9024
Mailing Address - Fax:
Practice Address - Street 1:3668 RETSOF RD
Practice Address - Street 2:
Practice Address - City:RETSOF
Practice Address - State:NY
Practice Address - Zip Code:14539-0300
Practice Address - Country:US
Practice Address - Phone:585-245-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295572164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse