Healthcare Provider Details

I. General information

NPI: 1467987933
Provider Name (Legal Business Name): NYSARC INC. ONTARIO COUNTY CHAPTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 08/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3071 COUNTY COMPLEX DR
CANANDAIGUA NY
14424-9505
US

IV. Provider business mailing address

3071 COUNTY COMPLEX DR
CANANDAIGUA NY
14424-9505
US

V. Phone/Fax

Practice location:
  • Phone: 585-394-7500
  • Fax: 585-394-1987
Mailing address:
  • Phone: 585-394-7500
  • Fax: 585-394-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ANN SCHEETZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 585-394-7500