Provider Demographics
NPI:1063655843
Name:EPILEPSY-PRALID, INC.
Entity Type:Organization
Organization Name:EPILEPSY-PRALID, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SINSEBOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-442-6420
Mailing Address - Street 1:2 TOWNLINE CIR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2536
Mailing Address - Country:US
Mailing Address - Phone:585-442-6420
Mailing Address - Fax:585-442-6964
Practice Address - Street 1:2 TOWNLINE CIR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2536
Practice Address - Country:US
Practice Address - Phone:585-442-6420
Practice Address - Fax:585-442-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03561786Medicaid
NY03562636Medicaid
NY03478782Medicaid
NY02138181Medicaid
NY02713019Medicaid
NY03035852Medicaid
NY03478755Medicaid
NY03478773Medicaid
NY01550641Medicaid
NY03532634Medicaid
NY02170950Medicaid
NY02248617Medicaid
NY03561777Medicaid
NY02663183Medicaid
NY03478764Medicaid
NY03532643Medicaid
NY03272566Medicaid
NY03532652Medicaid
NY03562287Medicaid
NY01736754Medicaid
NY02004635Medicaid
NY02011787Medicaid
NY02702147Medicaid
NY03532625Medicaid
NY03561795Medicaid
NY03718018Medicaid
NY03718150Medicaid