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Individual

ANNAMARIE PROSSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689
Mailing address
171 INTREPID LN, SYRACUSE, NY 13205-2548
(315) 437-4689

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03253596
NY
Enumeration date
04/28/2017
Last updated
04/28/2017
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