Individual
MARY ELIZABETH MACBLANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
750 E ADAMS ST, PEDIATRICS, SYRACUSE, NY 13210-2306
(315) 464-5259
(315) 464-6398
Mailing address
5235 BEAR RD, NORTH SYRACUSE, NY 13212-1213
(315) 464-5259
(315) 464-6398
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
325340-1
NY
363LP0200X
Pediatric Nurse Practitioner
F380760-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02218940
—
NY
Enumeration date
09/01/2006
Last updated
09/11/2025
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