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
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 309029 (NY) |
Gerontology Nurse Practitioner: Definition to come...
Another provider at this address
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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.