Healthcare Provider Details

I. General information

NPI: 1346880846
Provider Name (Legal Business Name): SEWAA LL.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 RAINIER ST
ROCHESTER NY
14613-2309
US

IV. Provider business mailing address

39 RAINIER ST
ROCHESTER NY
14613-2309
US

V. Phone/Fax

Practice location:
  • Phone: 585-752-6703
  • Fax:
Mailing address:
  • Phone: 585-752-6703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MAN B MAGAR
Title or Position: MANAGER
Credential: MD
Phone: 585-752-6703