Derouchie, Virginia Marie

Derouchie, Virginia Marie is an individual health care provider with primary practice located at 4 Commerce Lane , Canton NY 13617-3739. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Derouchie, Virginia Marie can be contacted via phone (315) 386-8191.

Contact Information

Primary practice address
4 Commerce Lane Canton NY 13617-3739
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 014695 New York

Profile Details

NPI number 1265558282
LBN Legal business name Derouchie, Virginia Marie
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Mar 7th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265558282 NPPES
New York MEDICAID 01995615

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