Provider Demographics
NPI:1851808703
Name:WYGAL, KAREN ANN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:WYGAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:207 WIMBLEDON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-4232
Mailing Address - Country:US
Mailing Address - Phone:585-467-8885
Mailing Address - Fax:
Practice Address - Street 1:NYS/OMH ROCHESTER PSYC. CENTER
Practice Address - Street 2:1111 ELMWOOD AVE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3005
Practice Address - Country:US
Practice Address - Phone:585-241-1700
Practice Address - Fax:585-241-1330
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY535406-1163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult