Randolph Moredock in Brockport - Mental Health
Randolph Moredock - NPI 1679585707
Randolph Moredock is a Mental Health in Brockport, New York. Randolph Moredock practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Randolph Moredock is 1679585707. The last update date is 2007-08-22.
Randolph Moredock's current location address is 60 Centennial Ave, Brockport, New York. You can contact this provider via phone number 5856375001. The mailing address for Randolph Moredock is 60 Centennial Ave, Brockport, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randolph Moredock |
|---|---|
| Address | 60 Centennial Ave, Brockport, New York |
| Phone Number | 5856375001 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1679585707 |
|---|---|
| Provider Enumeration Date | 2006-08-13 |
| Last Updated Date | 2007-08-22 |
Provider Mailing Address Detail
| Address | 60 Centennial Ave |
|---|---|
| City | Brockport |
| State | New York (NY) |
| Post Code | 144202328 |
| Phone Number | 5856375001 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | 18 002810 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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What is the unique 10-digit identification code assigned to Randolph Moredock by the Centers for Medicare & Medicaid Services?
The Randolph Moredock has been issued the NPI (National Provider Identifier) 1679585707, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Randolph Moredock is physically located?
The Randolph Moredock is situated at the following address: 60 Centennial Ave, Brockport, NY 144202328.
What is the Randolph Moredock's area of specialization and corresponding taxonomy classification?
The Randolph Moredock's specialty field is Mental Health, and it falls under the taxonomy code 101Ym0800X, which categorizes healthcare providers based on their specialties.
On what date was the 1679585707 assigned to Randolph Moredock?
The Randolph Moredock was issued its 1679585707 on 2006-08-13, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Randolph Moredock, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Randolph Moredock, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-08-22.