Provider Demographics
NPI:1356641773
Name:MESSEKO, FREIDA (LPN)
Entity Type:Individual
Prefix:
First Name:FREIDA
Middle Name:
Last Name:MESSEKO
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:PO BOX 23532
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14692-3532
Mailing Address - Country:US
Mailing Address - Phone:864-552-0251
Mailing Address - Fax:
Practice Address - Street 1:3124 ELMWOOD AVE APT 7
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2047
Practice Address - Country:US
Practice Address - Phone:864-552-0251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275561-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse