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NPI Code Detail

MEDICARE: NYSARC INC

MEDICARE: NYSARC INC
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
1261QD1600XDevelopmental Disabilities Clinic/Center

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 : 1457458424
Entity Type Code : Organization
Provider Name (Legal Business Name) : NYSARC INC
Provider Business Mailing Address
First Line : PO BOX 23438
Second Line :
City : ROCHESTER
State : NY
Zip : 14692-3438
Country : US
Telephone Number : 585-271-0660
Fax Number : 585-271-7950
Provider Business Practice Location Address
First Line : 2060 BRIGHTON HENRIETTA TOWN LINE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2792
Country : US
Telephone Number : 585-271-0660
Fax Number : 585-271-7950
Authorized Official
Title or Position : COO
Name : MS. BARBARA S WALE
Credential :
Telephone Number : 585-672-2233
Provider Enumeration Date : 09/20/2006
Last Update Date : 11/08/2010

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