Individual
MR. MICHAEL A DEROUCHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 FINNEY BLVD, MALONE, NY 12953-1067
(518) 481-8160
(518) 481-8161
Mailing address
35 DUANE ST APT 12, MALONE, NY 12953-2363
(315) 957-9701
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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