Individual
DIEGO VILLAMIZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(772) 532-0240
Mailing address
736 IRVING AVE, SYRACUSE, NY 13210-1687
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30366701
NY
Other
Enumeration date
05/04/2016
Last updated
07/09/2020
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