New York Medicaid

NPI #1972786309 in Auburn, New York

Provider Information

NPI Number: 1972786309
Entity Type: Organization
Organization Name: New York Medicaid
Primary Specialty: Nursing Care
Enumeration Date: Dec 7, 2007
Last Updated: Dec 7, 2007

Practice Location

Address: 10 FOURTH AVE
City: Auburn
State: New York
ZIP Code: 13021-5106
Phone: (315) 253-7629

Authorized Official

Name: SUSAN SCARSELLETTA
Title: LPN
Phone: (315) 253-7629

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nursing Care	251J00000X	Primary

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