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NPI Code Detail

MEDICARE: MS. KIM MARIE SADWICK PMHNP

MEDICARE: MS. KIM MARIE SADWICK PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner402012NY

General Provider Information

NPI Number : 1649615675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIM MARIE SADWICK PMHNP
Provider Business Mailing Address
First Line : 3300 DEWEY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-3741
Country : US
Telephone Number : 585-865-1550
Fax Number :
Provider Business Practice Location Address
First Line : 3300 DEWEY AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14616-3741
Country : US
Telephone Number : 585-865-1550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2013
Last Update Date : 06/21/2016

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