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NPI Code Detail

MEDICARE: NASCENTIA COMMUNITY CARE

MEDICARE: NASCENTIA COMMUNITY CARE
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
1251E00000XHome Health Agency3301606NY
2261QP2300XPrimary Care 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
23301330ROTHERNYOPERATING CERTIFICATE

General Provider Information

NPI Number : 1700870011
Entity Type Code : Organization
Provider Name (Legal Business Name) : NASCENTIA COMMUNITY CARE
Provider Business Mailing Address
First Line : 1050 W GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2215
Country : US
Telephone Number : 315-641-2385
Fax Number :
Provider Business Practice Location Address
First Line : 1050 W GENESEE ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2215
Country : US
Telephone Number : 315-641-2385
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MRS. MARY KATE ROLF
Credential :
Telephone Number : 315-477-9595
Provider Enumeration Date : 09/01/2005
Last Update Date : 02/20/2025

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Directions to “NASCENTIA COMMUNITY CARE ” Practice Location

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