Provider Demographics
NPI:1174198360
Name:MOHAWK VALLEY RN PLLC FRANK B. SOUZA
Entity type:Organization
Organization Name:MOHAWK VALLEY RN PLLC FRANK B. SOUZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:315-507-1344
Mailing Address - Street 1:1755 HIGBY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:NY
Mailing Address - Zip Code:13340-4322
Mailing Address - Country:US
Mailing Address - Phone:315-507-1344
Mailing Address - Fax:
Practice Address - Street 1:2209 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5930
Practice Address - Country:US
Practice Address - Phone:315-507-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty