Individual
ATHENA REOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
725 IRVING AVE STE 504, SYRACUSE, NY 13210-1683
(315) 464-8444
Mailing address
725 IRVING AVE STE 504, SYRACUSE, NY 13210-1683
(315) 464-8444
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
F383575-01
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F383575-01
NY
Other
Enumeration date
09/26/2023
Last updated
11/17/2023
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