Provider Demographics
NPI:1316389612
Name:BECKER, MOLLY (RN)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 PEARSON ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-5430
Mailing Address - Country:US
Mailing Address - Phone:585-313-9537
Mailing Address - Fax:
Practice Address - Street 1:78 PEARSON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-5430
Practice Address - Country:US
Practice Address - Phone:585-313-9537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-27
Last Update Date:2013-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY670384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse