Provider First Line Business Practice Location Address:
4900 BROAD RD
Provider Second Line Business Practice Location Address:
HOSPITALIST OFFICE @ COMMUNITY @ UPSTATE UNIVERSITY HOS
Provider Business Practice Location Address City Name:
SYRAUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-492-5305
Provider Business Practice Location Address Fax Number:
315-492-5320
Provider Enumeration Date:
11/02/2006