Healthcare Provider Details

I. General information

NPI: 1558634345
Provider Name (Legal Business Name): DAWN DOWNING RYCKMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 PANNELL RD
MACEDON NY
14502-9712
US

IV. Provider business mailing address

205 PANNELL RD
MACEDON NY
14502-9712
US

V. Phone/Fax

Practice location:
  • Phone: 585-733-9440
  • Fax:
Mailing address:
  • Phone: 315-986-8695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number447945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: