Provider Demographics
NPI:1306163647
Name:SCHROCK, CORYN
Entity type:Individual
Prefix:
First Name:CORYN
Middle Name:
Last Name:SCHROCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8249 GREENBUSH RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9422
Mailing Address - Country:US
Mailing Address - Phone:716-542-3510
Mailing Address - Fax:
Practice Address - Street 1:8249 GREENBUSH RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001-9422
Practice Address - Country:US
Practice Address - Phone:716-542-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251227-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse