Provider First Line Business Practice Location Address:
UPSTATE HEALTH CARE CENTER SUITE 1055
Provider Second Line Business Practice Location Address:
90 PRESIDENTIAL PLAZA
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13202-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-464-6395
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2020