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NPI Code Detail

MEDICARE: EVADNEY NESMITH

MEDICARE: EVADNEY NESMITH
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
11041S0200XSchool Social Worker084912NY

General Provider Information

NPI Number : 1699146993
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVADNEY NESMITH
Provider Business Mailing Address
First Line : 31 BRYAN ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14613-1714
Country : US
Telephone Number : 585-254-3110
Fax Number :
Provider Business Practice Location Address
First Line : 31 BRYAN ST
Second Line : VIRGIL GRISSOM SCHOOL 7
City : ROCHESTER
State : NY
Zip : 14613-1714
Country : US
Telephone Number : 585-254-3110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2015
Last Update Date : 10/13/2015

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Directions to “ EVADNEY NESMITH ” Practice Location

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