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General NPI Number Information
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NPI Number | 1548846884
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Entity Type | Individual
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Provider Name | MR. ROSCO ROBERT FINGAR SR.
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Gender | Male
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 93 ROWLAND ST
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City | BALLSTON SPA
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State | NY
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Zip | 12020-2566
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Country | US
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Telephone | 518-885-6514
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Fax | 518-885-6514
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Provider Business Mailing Address
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Address Line | 93 ROWLAND ST
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City | BALLSTON SPA
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State | NY
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Zip | 12020-2566
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Country | US
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Telephone | 518-885-6514
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Fax | 518-885-6514
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 640Q048
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License Number State | NY
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