Individual
MARY BETH EARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 273-1286
Mailing address
601 ELMWOOD AVE, BOX 679B, ROCHESTER, NY 14642-0001
(585) 273-3760
(585) 273-1129
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
374205
NY
363L00000X
Nurse Practitioner
Primary
300976
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03164216
—
NY
01
—
NP0784
PREFERRED CARE
NY
01
—
P019300976
BLUE CHOICE
NY
Enumeration date
08/21/2006
Last updated
07/05/2023
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