National Provider Identifier

Carol Marie Derycke, RN, BSN

Carol Marie Derycke, RN, BSN is listed in the NPPES registry with a primary specialty of Registered Nurse in Rochester, NY and a listed phone number of (585) 753-5163.

NPI 1891011433Rochester, NYRegistered Nurse

Profile Overview

NPI
1891011433
Provider Type
Individual
Primary Specialty
Registered Nurse
Enumeration Date
April 07, 2010
Last Updated
April 07, 2010

Practice Location

  • 111 Westfall RD Rm 864
  • Rochester, NY 14620-4647

Phone: (585) 753-5163

Mailing Address

  • 16 Sunset Trl
  • Fairport, NY 14450-1922

Specialties

  • Registered Nurse (163W00000X)
Full Record
NPI
1891011433
Entity Type
Individual
Last Name
Derycke
First Name
Carol
Middle Name
Marie
Name Prefix
Mrs.
Credential
RN, BSN
Mailing Street Address
16 Sunset Trl
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-1922
Mailing Country
US
Mailing Phone
(585) 753-5163
Mailing Fax
(585) 753-5188
Practice Street Address
111 Westfall RD Rm 864
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14620-4647
Practice Country
US
Practice Phone
(585) 753-5163
Practice Fax
(585) 753-5188
Enumeration Date
April 07, 2010
Last Updated
April 07, 2010
Sex
Female
Sole Proprietor
No
Taxonomies
Registered Nurse (163W00000X)