National Provider Identifier

Charles Thaddious Taylor Jr., LPN

Charles Thaddious Taylor Jr., LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 351-1003.

NPI 1730786070Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1730786070
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
October 08, 2020
Last Updated
October 08, 2020

Practice Location

  • 115 Chili Ave
  • Rochester, NY 14611-2604

Phone: (585) 351-1003

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1730786070
Entity Type
Individual
Last Name
Taylor
First Name
Charles
Middle Name
Thaddious
Name Prefix
Mr.
Name Suffix
Jr.
Credential
LPN
Mailing Street Address
115 Chili Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14611-2604
Mailing Country
US
Mailing Phone
(585) 351-1003
Practice Street Address
115 Chili Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14611-2604
Practice Country
US
Practice Phone
(585) 351-1003
Enumeration Date
October 08, 2020
Last Updated
October 08, 2020
Sex
Male
Sole Proprietor
Yes
Certification Date
October 08, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)