National Provider Identifier
Caitlin L Tillack, ANP
Caitlin L Tillack, ANP is listed in the NPPES registry with a primary specialty of Gerontology Nurse Practitioner in Canandaigua, NY and a listed phone number of (585) 394-1875.
Profile Overview
- NPI
- 1124588660
- Provider Type
- Individual
- Primary Specialty
- Gerontology Nurse Practitioner
- Enumeration Date
- March 21, 2019
- Last Updated
- March 18, 2025
Practice Location
- 401 S Main St Ste 200
- Canandaigua, NY 14424-2157
Phone: (585) 394-1875
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Gerontology Nurse Practitioner (363LG0600X)
Endpoints
- ctillack259953@direct.rochesterregional.org
Direct Messaging Address | Direct | Canandaigua, NY 14424
Full Record
- NPI
- 1124588660
- Entity Type
- Individual
- Last Name
- Tillack
- First Name
- Caitlin
- Middle Name
- L
- Credential
- ANP
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 922-1900
- Mailing Fax
- (585) 922-0636
- Practice Street Address
- 401 S Main St Ste 200
- Practice City
- Canandaigua
- Practice State
- NY
- Practice ZIP Code
- 14424-2157
- Practice Country
- US
- Practice Phone
- (585) 394-1875
- Practice Fax
- (585) 394-1878
- Enumeration Date
- March 21, 2019
- Last Updated
- March 18, 2025
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- March 18, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Gerontology Nurse Practitioner (363LG0600X)