Provider Demographics
NPI:1437955218
Name:SPERATO INDELICATO, INDIA (RN)
Entity type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:SPERATO INDELICATO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 GROVE DR APT 15B
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1682
Mailing Address - Country:US
Mailing Address - Phone:315-877-5788
Mailing Address - Fax:
Practice Address - Street 1:ROCHESTER PSYCH CENTER
Practice Address - Street 2:1111 ELMWOOD AVE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-241-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY621182163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health