Provider Demographics
NPI:1639384910
Name:LOQUASTO, LEWIS H (FNP-BC, L AC, RN)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:H
Last Name:LOQUASTO
Suffix:
Gender:M
Credentials:FNP-BC, L AC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 SENECA PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1019
Mailing Address - Country:US
Mailing Address - Phone:585-719-0779
Mailing Address - Fax:
Practice Address - Street 1:595 SENECA PKWY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1019
Practice Address - Country:US
Practice Address - Phone:585-719-0779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003520171100000X
NY341323363LF0000X
NY630632163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse