Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Mar 20, 2007
License(s)
F332257 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 57 NORTH ST | Camillus, NY 13031-1029 | 315-672-5117 |
| LOCATION | 736 IRVING AVE | Syracuse, NY 13210-1687 | 315-470-7111 |
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