Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keanu Tyler Vaccaro

Individual provider Licensed Practical Nurse · NPI 1285277319

Keanu Tyler Vaccaro is a Licensed Practical Nurse in Rochester, New York. Licensed in New York. Registered with an NPI since 2019.

Licensed in
NY
In the registry since
2019

Practice location Address checks out

40 Midland Ave
Rochester, NY 14621-4050
Phone: (719) 574-9115
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 312825 (NY)

Record details

NPI number1285277319
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 22, 2019
Last updated in NPPESDecember 23, 2022
Certification dateDecember 23, 2022

Other providers in Rochester