Provider Demographics
NPI:1972866598
Name:STILES, ROSE HARRINGTON
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:HARRINGTON
Last Name:STILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 S HILL RD
Mailing Address - Street 2:
Mailing Address - City:MC GRAW
Mailing Address - State:NY
Mailing Address - Zip Code:13101-9458
Mailing Address - Country:US
Mailing Address - Phone:607-836-6752
Mailing Address - Fax:
Practice Address - Street 1:60 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2795
Practice Address - Country:US
Practice Address - Phone:607-753-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No171M00000XOther Service ProvidersCase Manager/Care Coordinator