Individual
KIM SYRACUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2412 SENECA ST, BUFFALO, NY 14210-2662
(716) 566-6507
(866) 242-7286
Mailing address
227 THORN AVE, ORCHARD PARK, NY 14127-2600
(716) 662-2040
(716) 662-0019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
122033
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122033
NYS
NY
Enumeration date
05/08/2023
Last updated
11/17/2023
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