Provider Demographics
NPI:1720603269
Name:DELATORRE, MAGLIN JANET
Entity Type:Individual
Prefix:
First Name:MAGLIN
Middle Name:JANET
Last Name:DELATORRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 CONSTANCE WAY W
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-2750
Mailing Address - Country:US
Mailing Address - Phone:585-200-7524
Mailing Address - Fax:
Practice Address - Street 1:94 CONSTANCE WAY W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-2750
Practice Address - Country:US
Practice Address - Phone:585-200-7524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320906164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse