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Individual

BETSY B WATERMAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6569
(315) 298-7488
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6569
(315) 298-7488

Taxonomy

Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
012184
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00012184
NY
05
00307662
NY
01
331880
FQHC NUMBER
NY
Enumeration date
09/02/2005
Last updated
07/09/2007
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