Provider First Line Business Practice Location Address:
516 PROSPECT AVE
Provider Second Line Business Practice Location Address:
PEDIATRICS
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13208-2523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-703-5270
Provider Business Practice Location Address Fax Number:
315-703-5271
Provider Enumeration Date:
08/18/2006