Individual
JENNIFER CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
322 LAKE AVE, ROCHESTER, NY 14608-1017
(585) 254-6480
(585) 254-1092
Mailing address
480 GENESEE ST, ROCHESTER, NY 14611-3634
(585) 254-6480
(585) 254-1092
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
214505
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103401BF
PREFERRED CARE
NY
05
—
214505
—
NY
Enumeration date
07/20/2006
Last updated
07/09/2007
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