Individual
DR. AUDREY VICTORIA VANDEWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 408-5854
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101025536
MI
Other
Enumeration date
05/18/2017
Last updated
10/10/2022
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