Provider Demographics
NPI:1699808048
Name:DEUEL, COLLEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:M
Last Name:DEUEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:ROUTE 36 SONYEA ROAD
Mailing Address - City:SONYEA
Mailing Address - State:NY
Mailing Address - Zip Code:14556-0049
Mailing Address - Country:US
Mailing Address - Phone:585-658-3710
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 36 SONYEA ROAD
Practice Address - Street 2:STATE OF NEW YORK DEPT HEALTH
Practice Address - City:SONYEA
Practice Address - State:NY
Practice Address - Zip Code:14556-0049
Practice Address - Country:US
Practice Address - Phone:585-658-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215493207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology