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Individual

ANN SUTERA BOTASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
90 PRESIDENTIAL PLZ, 3RD FLOOR, SYRACUSE, NY 13202-2240
(315) 464-4357
(315) 464-2030
Mailing address
90 PRESIDENTIAL PLZ, 3RD FLOOR, SYRACUSE, NY 13202-2240
(315) 464-4357
(315) 464-2030

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
170003
NY
2080C0008X
Child Abuse Pediatrics Physician
170003
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01185377
NY
Enumeration date
07/20/2006
Last updated
05/07/2010
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