Provider Demographics
NPI:1740740307
Name:FOSTANO, SANDRA ERIN (FNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ERIN
Last Name:FOSTANO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:CROAKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1561 LONG POND RD STE 303
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4135
Mailing Address - Country:US
Mailing Address - Phone:585-368-6500
Mailing Address - Fax:585-368-6501
Practice Address - Street 1:1561 LONG POND RD STE 303
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4135
Practice Address - Country:US
Practice Address - Phone:585-368-6500
Practice Address - Fax:585-368-6501
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily