Individual provider · Type 1 NPI

Caitlin L. Tillack, ANP

Gerontology Nurse Practitioner · Canandaigua, NY

NPI number 1124588660 Active

Practice location

401 S Main St Ste 200
Canandaigua, NY 14424-2157

Fax (585) 394-1878

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X309029 (NY)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1124588660

Caitlin L. Tillack, ANP's National Provider Identifier is 1124588660, issued on Mar 21, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Canandaigua, NY. The record was last updated on Mar 18, 2025.