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General NPI Number Information
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NPI Number | 1174198360
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Entity Type | Organization
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Legal Business Name | MOHAWK VALLEY RN PLLC FRANK B. SOUZA
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 2209 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-5930
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Country | US
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Telephone | 315-507-1344
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Fax |
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Provider Business Mailing Address
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Address Line | 1755 HIGBY RD
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City | FRANKFORT
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State | NY
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Zip | 13340-4322
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Country | US
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Telephone | 315-507-1344
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FRANK BRIAN SOUZA
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Credential | CRNFA
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Telephone | 315-507-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State |
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