Provider Demographics
NPI:1407158447
Name:CIMINO, MARIE ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:ROSE
Last Name:CIMINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17 BRIGHT AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-1276
Mailing Address - Country:US
Mailing Address - Phone:585-966-4500
Mailing Address - Fax:585-581-8123
Practice Address - Street 1:320 W CRAIG HILL DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3449
Practice Address - Country:US
Practice Address - Phone:585-966-4500
Practice Address - Fax:585-581-8123
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299062-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse