Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Sep 2, 2022
License(s)
349694 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 750 E ADAMS ST | Syracuse, NY 13210-2306 | 315-464-8200 |
| LOCATION | 750 E ADAMS ST | Syracuse, NY 13210-2306 | 315-464-8200 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.