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NPI Code Detail

MEDICARE: MR. GREGORY RICE LCSW-R

MEDICARE: MR. GREGORY RICE LCSW-R
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
11041C0700XClinical Social Worker079836NY

General Provider Information

NPI Number : 1235648718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY RICE LCSW-R
Provider Business Mailing Address
First Line : 120 BUNN HILL RD
Second Line :
City : VESTAL
State : NY
Zip : 13850-5907
Country : US
Telephone Number : 607-340-5400
Fax Number :
Provider Business Practice Location Address
First Line : 217 JEFFERSON AVE
Second Line :
City : ENDICOTT
State : NY
Zip : 13760-5244
Country : US
Telephone Number : 607-340-5400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2017
Last Update Date : 07/19/2024

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