Provider First Line Business Practice Location Address:
DEPARTMENT OF MEDICINE MSG
Provider Second Line Business Practice Location Address:
90 PRESIDENTIAL PLAZA, FIRM C
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-646-3834
Provider Business Practice Location Address Fax Number:
315-464-3837
Provider Enumeration Date:
03/23/2019