Individual
MARIAH SHERADIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2818 COUNTY ROAD 6, GENEVA, NY 14456-1445
(315) 945-8515
Mailing address
2818 COUNTY ROAD 6, GENEVA, NY 14456-9564
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
775112
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
775112
NURSING LICENSE
NY
Enumeration date
12/15/2021
Last updated
12/15/2021
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