Individual
CRYSTAL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87 WASHINGTON ST, RENSSELAER, NY 12144
(511) 844-9114
Mailing address
PO BOX 148, RENSSELAER, NY 12144
(518) 449-1142
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
648331
NY
Other
Enumeration date
01/07/2009
Last updated
11/27/2023
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