Provider Demographics
NPI:1710011002
Name:HALL, FRANK III (RN)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:HALL
Suffix:III
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 1:431 WINONA BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3746
Mailing Address - Country:US
Mailing Address - Phone:585-342-4827
Mailing Address - Fax:
Practice Address - Street 1:431 WINONA BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3746
Practice Address - Country:US
Practice Address - Phone:585-342-4827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY424629-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01348190Medicaid