Individual
EMILY SUZANNE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7375 OSWEGO RD STE 1, LIVERPOOL, NY 13090-3717
(315) 291-0064
Mailing address
7375 OSWEGO RD STE 1, LIVERPOOL, NY 13090-3717
(315) 291-0064
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
029170
NY
363A00000X
Physician Assistant
085.009502
IL
363A00000X
Physician Assistant
10004125A
IN
363A00000X
Physician Assistant
50.007894RX
OH
363A00000X
Physician Assistant
5601011450
MI
363A00000X
Physician Assistant
61021047
WA
363A00000X
Physician Assistant
7390-23
WI
363A00000X
Physician Assistant
C06628
MD
363A00000X
Physician Assistant
MA064853
PA
363A00000X
Physician Assistant
PA2022-0126
NM
363A00000X
Physician Assistant
PA9117452
FL
Other
Enumeration date
11/06/2017
Last updated
11/11/2023
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