Provider Demographics
NPI:1831120294
Name:LAWLOR, CECILIA SEVERINO (RN, NP)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:SEVERINO
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RED CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4272
Mailing Address - Country:US
Mailing Address - Phone:585-486-0600
Mailing Address - Fax:585-486-0649
Practice Address - Street 1:125 RED CREEK DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4272
Practice Address - Country:US
Practice Address - Phone:585-486-0600
Practice Address - Fax:585-486-0649
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301889-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111795CAOtherPREFERRED CARE
NYP01642Medicare UPIN
NY111795CAOtherPREFERRED CARE