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Organization

FAYETTEVILLE FAMILY PHYSICIAN, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HDAYATU SALAWU M.D. (PHYSICIAN)
(315) 214-3999
Entity
Organization

Contact information

Practice address
6834 E GENESEE ST, FAYETTEVILLE, NY 13066-1021
(315) 214-3999
(347) 772-3132
Mailing address
6834 EAST GENESEE STREET, FAYETTEVILLE, NY 13066
(315) 214-3999
(347) 772-3132

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2462581
NY

Other

Enumeration date
10/27/2011
Last updated
10/27/2011
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