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Individual
Inactive
Individual
Inactive
Sole proprietor
Provider details
NPI number
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
R041141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026439601
UNIVERA HEALTHCARE
NY
01
—
000590231001
BC/BS OF WNY
NY
01
—
552890
VALUE OPTIONS
NY
01
—
6290274
INDEPENDENT HEALTH
NY
Enumeration date
—
Last updated
—
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