MEDICARE: CAROL COY 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
1	363L00000X	Nurse Practitioner	F400521-01	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F400521-1	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1841304656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL COY NP

Provider Business Mailing Address
First Line	:	PO BOX 505
Second Line	:
City	:	NORTH CHILI
State	:	NY
Zip	:	14514-0505
Country	:	US
Telephone Number	:	585-594-5995
Fax Number	:	585-594-5425

Provider Business Practice Location Address
First Line	:	4201 BUFFALO ROAD, SUITE 1
Second Line	:
City	:	NORTH CHILI
State	:	NY
Zip	:	14514-1256
Country	:	US
Telephone Number	:	585-594-5995
Fax Number	:	585-594-5425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	05/01/2023

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Directions to “ CAROL COY NP” Practice Location

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