Provider Demographics
NPI:1497036305
Name:VACCARO, ANNETTE (RN)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:VACCARO
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 1:88 FOX HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3639
Mailing Address - Country:US
Mailing Address - Phone:845-876-6823
Mailing Address - Fax:845-876-5362
Practice Address - Street 1:88 FOX HOLLOW RD
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3639
Practice Address - Country:US
Practice Address - Phone:845-876-6823
Practice Address - Fax:845-876-5362
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY569350163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse