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NPI Code Detail

MEDICARE: PAUL M DRAKE LMSW

MEDICARE: PAUL M DRAKE LMSW
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 Worker132461702NY

General Provider Information

NPI Number : 1538894365
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL M DRAKE LMSW
Provider Business Mailing Address
First Line : 600 PARK AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-2926
Country : US
Telephone Number : 585-206-7280
Fax Number :
Provider Business Practice Location Address
First Line : 600 PARK AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14607-2926
Country : US
Telephone Number : 585-206-7280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2022
Last Update Date : 07/16/2022

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Directions to “ PAUL M DRAKE LMSW” Practice Location

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