Provider First Line Business Practice Location Address:
301 PROSPECT AVE
Provider Second Line Business Practice Location Address:
NICU
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13203-1807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-448-5111
Provider Business Practice Location Address Fax Number:
315-703-5079
Provider Enumeration Date:
02/14/2007