Organization
NEW YORK MEDICAID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SCARSELLETTA (LPN)
(315) 253-7629
Entity
Organization
Contact information
Practice address
10 FOURTH AVE, AUBURN, NY 13021-5106
(315) 253-7629
Mailing address
10 FOURTH AVE, AUBURN, NY 13021
(315) 253-7629
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
137288-1
NY
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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