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NPI Code Detail

MEDICARE: JANICE ROSS CASAC

MEDICARE: JANICE ROSS CASAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073841193
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE ROSS CASAC
Provider Business Mailing Address
First Line : 79 GLENRIDGE RD
Second Line :
City : GLENVILLE
State : NY
Zip : 12302-4523
Country : US
Telephone Number : 518-952-8408
Fax Number : 518-399-6860
Provider Business Practice Location Address
First Line : 556 CLINTON AVE S
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1105
Country : US
Telephone Number : 585-442-8422
Fax Number : 585-442-8494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2009
Last Update Date : 03/17/2018

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