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NPI Code Detail

MEDICARE: CAROLE P MCCLARY NP

MEDICARE: CAROLE P MCCLARY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner289120NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417052101
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE P MCCLARY NP
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-922-8400
Fax Number :
Provider Business Practice Location Address
First Line : 4302 GATEWAY DR
Second Line :
City : GENESEO
State : NY
Zip : 14454-9449
Country : US
Telephone Number : 585-922-8400
Fax Number : 585-922-8405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 01/12/2026

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Directions to “ CAROLE P MCCLARY NP” Practice Location

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