Individual
MARY E HACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
34 LITTLE SPRING RUN, FAIRPORT, NY 14450-3204
(585) 248-8723
Mailing address
34 LITTLE SPRING RUN, FAIRPORT, NY 14450-3204
(585) 248-8723
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
251E00000X
NY
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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