Provider Demographics
NPI:1467744870
Name:PETERSON, CAROL JEANNE (MS, CGC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEANNE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF ROCHESTER MEDICAL CTR
Mailing Address - Street 2:601 ELMWOOD AVENUE- BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-487-3480
Mailing Address - Fax:585-334-6292
Practice Address - Street 1:500 RED CREEK DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4284
Practice Address - Country:US
Practice Address - Phone:585-487-3480
Practice Address - Fax:585-334-6292
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS