Larson, Mark R.

Larson, Mark R. is an individual health care provider with primary practice located at 130 Allens Creek Rd , Rochester NY 14618-3305. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Larson, Mark R. can be contacted via phone (585) 473-5810.

Contact Information

Primary practice address
130 Allens Creek Rd Rochester NY 14618-3305
Phone: (585) 473-5810
Fax: (585) 473-5193
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 013650 New York

Profile Details

NPI number 1124088208
LBN Legal business name Larson, Mark R.
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124088208 NPPES
New York Other 106063FC PREFERRED CARE
New York Other 7043329 PREFERRED CARE
New York Other S13650-7W PREFERRED CARE

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