Provider Demographics
NPI:1205979663
Name:DUCEY, KARYN A (RN)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:A
Last Name:DUCEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 WREN FIELD LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9533
Mailing Address - Country:US
Mailing Address - Phone:585-248-9627
Mailing Address - Fax:
Practice Address - Street 1:48 WREN FIELD LN
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-9533
Practice Address - Country:US
Practice Address - Phone:585-248-9627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY501812-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02784196Medicaid