Individual
MR. TERESA M ROCHE-MCKEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
128 N DIVISION ST, AUBURN, NY 13021-1707
(315) 258-3940
Mailing address
128 N DIVISION ST, AUBURN, NY 13021-1707
(315) 258-3940
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
479567-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02131506
—
NY
Enumeration date
09/19/2007
Last updated
09/19/2007
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