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General NPI Number Information
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NPI Number | 1699808048
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Entity Type | Individual
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Provider Name | COLLEEN M DEUEL MD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | ROUTE 36 SONYEA ROAD STATE OF NEW YORK DEPT HEALTH
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City | SONYEA
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State | NY
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Zip | 14556-0049
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Country | US
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Telephone | 585-658-3710
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 49 ROUTE 36 SONYEA ROAD
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City | SONYEA
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State | NY
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Zip | 14556-0049
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Country | US
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Telephone | 585-658-3710
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 215493
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License Number State | NY
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