Individual
MRS. CAROL MARIE DERYCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
111 WESTFALL RD RM 864, ROCHESTER, NY 14620-4647
(585) 753-5163
(585) 753-5188
Mailing address
16 SUNSET TRL, FAIRPORT, NY 14450-1922
(585) 753-5163
(585) 753-5188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
443882-1
NY
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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