Individual
STEPHANIE ANN-PHILLIPS ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1602
(315) 470-7111
Mailing address
736 IRVING AVE, SYRACUSE, NY 13210-1602
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/09/2023
Last updated
02/07/2025
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