Organization
34HOME NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN A BERRY (LPN)
(315) 585-4445
Entity
Organization
Contact information
Practice address
5121 WEST LAKE ROAD, CANANDAIGUA, NY 14424
(585) 396-2001
Mailing address
638 YALE FARM RD, ROMULUS, NY 14541-9718
(315) 585-4445
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
124749-1
NY
Other
Enumeration date
11/13/2006
Last updated
06/13/2008
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