1902881113 NPI number — MS. BARBARA ANN RACO LSCW R

Table of content: MS. BARBARA ANN RACO LSCW R (NPI 1902881113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902881113 NPI number — MS. BARBARA ANN RACO LSCW R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RACO
Provider First Name:
BARBARA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSCW R
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902881113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 N GOODMAN ST
Provider Second Line Business Mailing Address:
STE 111
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14607-1554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-271-3760
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 N GOODMAN ST
Provider Second Line Business Practice Location Address:
STE 111
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14607-1554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-271-3760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 102052FK . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 16412 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 748307 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2177456 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7700263 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0214L147 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com