Individual
CARLA KAREN FACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
100 FALSTAFF ROAD, ROCHESTER, NY 14609-1884
(585) 305-0801
Mailing address
100 FALSTAFF RD, ROCHESTER, NY 14609-5543
(585) 305-0801
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
284396-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215297858
—
NY
Enumeration date
05/16/2012
Last updated
06/19/2013
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