Provider Demographics
NPI:1568107498
Name:TAGLIALATELA, MEGAN ROSE (RN)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:ROSE
Last Name:TAGLIALATELA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4245 W WALWORTH RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-9313
Mailing Address - Country:US
Mailing Address - Phone:585-797-7462
Mailing Address - Fax:
Practice Address - Street 1:43 OLD FARM CIR
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3005
Practice Address - Country:US
Practice Address - Phone:585-797-7462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730579163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse