Healthcare Provider Details

I. General information

NPI: 1003157462
Provider Name (Legal Business Name): EILEEN L AREND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 YARMOUTH RD
ROCHESTER NY
14610-1943
US

IV. Provider business mailing address

60 YARMOUTH RD
ROCHESTER NY
14610-1943
US

V. Phone/Fax

Practice location:
  • Phone: 585-482-3783
  • Fax:
Mailing address:
  • Phone: 585-482-3783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number599207
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: