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General NPI Number Information
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NPI Number | 1417284704
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Entity Type | Individual
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Provider Name | LINDSAY SOMMERS VIDLER MSW
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Gender | Female
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 426 LYELL AVE
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City | ROCHESTER
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State | NY
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Zip | 14606-1638
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Country | US
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Telephone | 585-719-2027
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Fax |
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Provider Business Mailing Address
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Address Line | 930 CODDINGTON RD
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City | ITHACA
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State | NY
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Zip | 14850-6022
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Country | US
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Telephone | 607-592-3088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P73431
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License Number State | NY
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