MEDICARE: EILEEN ROHAN M.S., C.A.S.

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
1	103TS0200X	School Psychologist	20944927	OH

General Provider Information

NPI Number	:	1831514694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN ROHAN M.S., C.A.S.

Provider Business Mailing Address
First Line	:	40 DELAWARE AVE
Second Line	:
City	:	HORNELL
State	:	NY
Zip	:	14843-2057
Country	:	US
Telephone Number	:	607-382-9839
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 E 55TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-4406
Country	:	US
Telephone Number	:	216-404-5642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2014
Last Update Date	:	03/03/2014

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