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NPI Code Detail

MEDICARE: MRS. TRACI-LYNN MARIE FARLEY M.S., CCC-A

MEDICARE: MRS. TRACI-LYNN MARIE FARLEY M.S., CCC-A
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
1237600000XAudiologist-Hearing Aid Fitter001861-1NY

General Provider Information

NPI Number : 1194788406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACI-LYNN MARIE FARLEY M.S., CCC-A
Provider Business Mailing Address
First Line : 183 WOODSONG LN
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-4161
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3599 BIG RIDGE RD
Second Line :
City : SPENCERPORT
State : NY
Zip : 14559-1709
Country : US
Telephone Number : 585-352-2400
Fax Number : 585-352-2651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 09/30/2011

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