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NPI Code Detail

MEDICARE: MRS. SADIE RUTH HARRING

MEDICARE: MRS. SADIE RUTH HARRING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker0706121NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255616868
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SADIE RUTH HARRING
Provider Business Mailing Address
First Line : 485 N CLINTON AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-1817
Country : US
Telephone Number : 585-325-7828
Fax Number : 585-262-8962
Provider Business Practice Location Address
First Line : 485 N CLINTON AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-1817
Country : US
Telephone Number : 585-325-7828
Fax Number : 585-262-8962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2011
Last Update Date : 10/14/2011

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