Organization
LORETTO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARY JO WEINHEIMER MS ANP-C (NURSE PRACTITIONER)
(315) 413-3606
Entity
Organization
Contact information
Practice address
700 E BRIGHTON AVE, SYRACUSE, NY 13205-2201
(315) 413-3606
Mailing address
301 WINKWORTH PKWY, SYRACUSE, NY 13215-1549
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
307106
NY
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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