Individual
MRS. TRACEY JO RHEAUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
725 IRVING AVENUE SUITE 112, CENTER FOR NEURODEVELOPMEMTL PEDIATRICS CROUSE POB, SYRACUSE, NY 13210-1624
(315) 464-2089
(315) 464-6398
Mailing address
750 E ADAMS ST, DEPT OF PEDIATRICS, SYRACUSE, NY 13210-2342
(315) 464-2089
(315) 464-6398
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381083-1
NY
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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