Individual
MRS. KAREN ANN BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7111
Mailing address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7111
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300773-1
NY
Other
Enumeration date
10/31/2012
Last updated
10/31/2012
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