Individual
MRS. SUSAN M DERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
117 SEAFARERS LN, ROCHESTER, NY 14612-2947
(585) 723-0713
Mailing address
117 SEAFARERS LN, ROCHESTER, NY 14612-2947
(585) 723-0713
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
416803-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01649229
—
NY
Enumeration date
11/01/2006
Last updated
07/08/2007
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