Individual
MR. KENNETH J. CUDA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MSN, CRNA
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210
(315) 470-7111
Mailing address
3325 MISTY COVE CIR, BALDWINSVILLE, NY 13027-9277
(315) 256-8038
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
122085
NY
390200000X
Student in an Organized Health Care Education/Training Program
645646
NY
Other
Enumeration date
03/06/2018
Last updated
07/29/2018
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