Individual
MR. BENJAMIN I CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R-PA
Contact information
Practice address
2700 COURT ST, SYRACUSE, NY 13208-3295
(315) 455-7610
Mailing address
2700 COURT ST, SYRACUSE, NY 13208-3295
(315) 455-7610
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011039-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02729197
—
NY
Enumeration date
01/18/2006
Last updated
11/15/2011
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