Individual
CAROLYN R BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
777 CLINTON AVE S, ROCHESTER, NY 14620-1401
(585) 279-4800
(585) 442-8319
Mailing address
777 CLINTON AVE S, ROCHESTER, NY 14620-1401
(585) 279-4800
(585) 442-8319
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
330028
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP0405
PREFERRED CARE
NY
01
—
P019330028
BLUE CHOICE
NY
Enumeration date
07/11/2006
Last updated
07/23/2007
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