Individual
CAROL JEAN BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
224 PERSHING DR, ROCHESTER, NY 14609-4120
(585) 654-6185
Mailing address
224 PERSHING DRIVE, ROCHESTER, NY 14609
(585) 654-6185
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307911
NY
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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