Braddock, Carolyn R

Braddock, Carolyn R is an individual health care provider with primary practice located at 777 Clinton Ave S , Rochester NY 14620-1401. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Braddock, Carolyn R can be contacted via phone (585) 279-4800.

Contact Information

Primary practice address
777 Clinton Ave S Rochester NY 14620-1401
Phone: (585) 279-4800
Fax: (585) 442-8319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 330028 New York

Profile Details

NPI number 1669406864
LBN Legal business name Braddock, Carolyn R
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 23rd, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669406864 NPPES
New York Other P019330028 BLUE CHOICE
New York Other NP0405 BLUE CHOICE

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