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Individual

CAROL LAREAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1676 SUNSET AVE, UTICA, NY 13502-5416
(315) 624-5226
(315) 624-5152
Mailing address
118 FAIRWAY DR, NEW HARTFORD, NY 13413-1008

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F331631
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
F331631
NY
Enumeration date
10/05/2006
Last updated
07/08/2007
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