Healthcare Provider Details

I. General information

NPI: 1093957607
Provider Name (Legal Business Name): DAWN MARIE PERRY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WESTFALL RD ROOM 161
ROCHESTER NY
14620-4647
US

IV. Provider business mailing address

111 WESTFALL RD ROOM 161
ROCHESTER NY
14620-4647
US

V. Phone/Fax

Practice location:
  • Phone: 585-753-5150
  • Fax: 585-753-5169
Mailing address:
  • Phone: 585-753-5150
  • Fax: 585-753-5169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number341341-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: