Provider Demographics
NPI:1245781442
Name:LINO, MARIA (LPN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LINO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-2513
Mailing Address - Country:US
Mailing Address - Phone:585-615-0179
Mailing Address - Fax:
Practice Address - Street 1:129 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2513
Practice Address - Country:US
Practice Address - Phone:585-615-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-22
Last Update Date:2016-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10327063164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse