Healthcare Provider Details

I. General information

NPI: 1790964757
Provider Name (Legal Business Name): ROSEMARIE M MCGOWAN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 DUNCAN ST
WARSAW NY
14569-1017
US

IV. Provider business mailing address

5 SAINT MARKS ST
LE ROY NY
14482-1023
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-0190
  • Fax:
Mailing address:
  • Phone: 585-356-9557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: