Provider Demographics
NPI:1215000377
Name:CASE, MOLLY B (RN)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:B
Last Name:CASE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6301 INDUCON DR E
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9014
Mailing Address - Country:US
Mailing Address - Phone:716-731-2030
Mailing Address - Fax:716-731-3010
Practice Address - Street 1:6301 INDUCON DR E
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132-9014
Practice Address - Country:US
Practice Address - Phone:716-731-2030
Practice Address - Fax:716-731-3010
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY489781-1163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY489781-1OtherRN