Healthcare Provider Details

I. General information

NPI: 1366892903
Provider Name (Legal Business Name): ASHLEY CUYLEAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CHI MAR DR
ROCHESTER NY
14624-4055
US

IV. Provider business mailing address

19 CHI MAR DR
ROCHESTER NY
14624-4055
US

V. Phone/Fax

Practice location:
  • Phone: 585-474-3701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number10 324986
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: