Individual
MR. DEAN STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
329 N SALINA ST, SYRACUSE, NY 13203-1755
(315) 474-5506
Mailing address
104 SCHOECK AVE, SYRACUSE, NY 13203-1127
(315) 427-6313
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401832
NY
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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