Individual
PAMELA BANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEDORTHIST
Contact information
Practice address
216 W GENESEE ST, SYRACUSE, NY 13202-1038
(315) 395-3872
Mailing address
216 W GENESEE ST, SYRACUSE, NY 13202-1038
(315) 395-3872
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
NY
332BC3200X
Customized Equipment (DME)
—
NY
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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