Individual
KAYSON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
614 S SALINA ST, SYRACUSE, NY 13202-3500
(315) 425-0599
Mailing address
614 S SALINA ST, SYRACUSE, NY 13202-3500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402691
NY
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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