Individual ProviderDerry MicaleMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address5496 E Taft Rd, North Syracuse, NY 13212-3784(315) 552-6700PECOS EnrollmentBased on the most recent information from CMS, provider Derry Micale does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1912319690Provider TypeIndividualFull NameMicale, DerryCredentialLMTGenderFemaleSole ProprietorYesEnumeration Date5/29/2014Last Updated5/29/2014Contact InformationPractice LocationPractice Address5496 E Taft Rd, North Syracuse, NY 13212-3784Phone(315) 552-6700Fax(315) 552-6701Mailing LocationMailing Address5496 E Taft Rd, North Syracuse, NY 13212-3784Phone(315) 552-6700Fax(315) 552-6701Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense024204New York