| Essentia Telehealth And Wellness | |
|
110 Mechanic St Fayetteville NY 13066-1333 | |
| (505) 365-1519 | |
| (315) 637-8557 |
| Full Name | Essentia Telehealth And Wellness |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 110 Mechanic St, Fayetteville, New York |
| Authorized Official Name and Position | Enrique Antonio Rosario (CO-OWNER) |
| Authorized Official Contact | 5053651519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentia Telehealth And Wellness 110 Mechanic St Fayetteville NY 13066-1333 Ph: (505) 365-1519 | Essentia Telehealth And Wellness 110 Mechanic St Fayetteville NY 13066-1333 Ph: (505) 365-1519 |
| NPI Number | 1104668839 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104668839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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