Individual
ASHLEY PENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 INTREPID LANE, SYRACUSE, NY 13205
(315) 212-1816
Mailing address
171 INTREPID LANE, SYRACUSE, NY 13205
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/17/2015
Last updated
11/02/2015
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