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General NPI Number Information
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NPI Number | 1073820460
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Entity Type | Organization
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Legal Business Name | DEW RESOURCES, INC.
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 14 MARC MAR TRL
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City | ROCHESTER
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State | NY
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Zip | 14606-3548
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Country | US
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Telephone | 585-426-2281
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Fax | 585-721-6114
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Provider Business Mailing Address
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Address Line | 14 MARC MAR TRL
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City | ROCHESTER
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State | NY
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Zip | 14606-3548
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Country | US
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Telephone | 585-426-2281
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Fax | 585-721-6114
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ELLIOTT GLOVER
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Credential |
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Telephone | 585-721-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 953624803
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License Number State | NY
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