MEDICARE: SOLACE AGBLEVOR

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	163W00000X	Registered Nurse	803139	NY

General Provider Information

NPI Number	:	1568347813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLACE AGBLEVOR

Provider Business Mailing Address
First Line	:	300 SOUTH RD
Second Line	:
City	:	BROOKTONDALE
State	:	NY
Zip	:	14817-9722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 SOUTH RD
Second Line	:
City	:	BROOKTONDALE
State	:	NY
Zip	:	14817-9722
Country	:	US
Telephone Number	:	607-539-4706
Fax Number	:

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

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

Similar Medicare Providers

1477718690 — DR. KEITH M. BELL D.D.S
Practice Location Address:

300 SOUTH RD
BROOKTONDALE, NY
14817-9722

Practice Phone: 607-539-7121
Practice Fax:

1649582354 — KAREN LYNN RAEDER FNP
Practice Location Address:

300 SOUTH RD
BROOKTONDALE, NY
14817-9722

Practice Phone: 607-539-7121
Practice Fax:

1275728727 — KELLY RAE LADD-PERO RN
Practice Location Address:

237 BURNS RD
BROOKTONDALE, NY
14817-9539

Practice Phone: 607-539-6968
Practice Fax:

1558549873 — CHERRISE A LOCKWOOD
Practice Location Address:

7 LIDDINGTON RD
BROOKTONDALE, NY
14817-9607

Practice Phone: 607-539-6729
Practice Fax:

1093962060 — SARAH MICHELLE SLP
Practice Location Address:

547 VALLEY RD
BROOKTONDALE, NY
14817-9702

Practice Phone: 607-220-7813
Practice Fax:

1972805745 — JACQUELINE MARIE SEELY R.N.
Practice Location Address:

53 N LOUNSBERRY RD , LOT2
BROOKTONDALE, NY
14817-9405

Practice Phone: 607-539-6503
Practice Fax:

Directions to “ SOLACE AGBLEVOR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.