Provider Demographics
NPI:1871258731
Name:SANGANETTI, CAITLIN (NP)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:SANGANETTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 665
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-5321
Mailing Address - Fax:585-276-1202
Practice Address - Street 1:156 WEST AVE
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1229
Practice Address - Country:US
Practice Address - Phone:585-275-5321
Practice Address - Fax:585-276-1202
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY686452-01163W00000X
NY350022207RC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine