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:
Health care specialties
Specialty | Code | License # | 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 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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