MEDICARE: MR. SCOTT R.W. GREFRATH LCSW-R

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
1	1041C0700X	Clinical Social Worker	R074546-1	NY

General Provider Information

NPI Number	:	1528075710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT R.W. GREFRATH LCSW-R

Provider Business Mailing Address
First Line	:	31 BIRCHWOOD DR
Second Line	:
City	:	BATAVIA
State	:	NY
Zip	:	14020-2944
Country	:	US
Telephone Number	:	585-356-1744
Fax Number	:	585-219-4583

Provider Business Practice Location Address
First Line	:	55 TROUP ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14608-2053
Country	:	US
Telephone Number	:	585-546-1271
Fax Number	:	585-546-2607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	04/08/2011

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