Healthcare Provider Details

I. General information

NPI: 1932597432
Provider Name (Legal Business Name): VISITING NURSE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2015
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 RIDGE RD
WEBSTER NY
14580-1750
US

IV. Provider business mailing address

581 RIDGE RD
WEBSTER NY
14580-1750
US

V. Phone/Fax

Practice location:
  • Phone: 585-750-3980
  • Fax:
Mailing address:
  • Phone: 585-750-3980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number265867
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number265867
License Number StateNY

VIII. Authorized Official

Name: MS. KATHLEEN ROSE DESTEFANO
Title or Position: TRIAGE NURSE
Credential: RN
Phone: 585-787-2233