Provider Demographics
NPI:1326054362
Name:ROOKS, MARY J (CNM)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:J
Last Name:ROOKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 STATE ROUTE 86
Mailing Address - Street 2:WOMEN'S HEALTH CLINC
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5644
Mailing Address - Country:US
Mailing Address - Phone:518-897-2361
Mailing Address - Fax:518-897-2759
Practice Address - Street 1:2233 STATE ROUTE 86
Practice Address - Street 2:WOMEN'S HEALTH CLINC
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5644
Practice Address - Country:US
Practice Address - Phone:518-897-2361
Practice Address - Fax:518-897-2759
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000907-1176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02225125Medicaid
NY02225125Medicaid