Provider Demographics
NPI:1225416910
Name:CANTY, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:CANTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 LAKE VISTA CT APT 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-5324
Mailing Address - Country:US
Mailing Address - Phone:585-369-5318
Mailing Address - Fax:
Practice Address - Street 1:72 LAKE VISTA CT APT 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-5324
Practice Address - Country:US
Practice Address - Phone:585-369-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301158-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse