Provider Demographics
NPI:1962772590
Name:PANKRATH, MARIA E (LPN)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:E
Last Name:PANKRATH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HALLMARK RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-1333
Mailing Address - Country:US
Mailing Address - Phone:585-507-6396
Mailing Address - Fax:
Practice Address - Street 1:1 HALLMARK RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-1333
Practice Address - Country:US
Practice Address - Phone:585-507-6396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308248-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse