Provider Demographics
NPI:1033224662
Name:ROACH, FRANCES (MSN)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:ROACH
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 STONELEIGH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2454
Mailing Address - Country:US
Mailing Address - Phone:845-279-5908
Mailing Address - Fax:845-279-5447
Practice Address - Street 1:667 STONELEIGH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:845-279-5908
Practice Address - Fax:845-279-5447
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174820-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR05601Medicare ID - Type Unspecified