Individual
MRS. MICHELLE MARGARET EDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.,M.A., P.A.-C
Contact information
Practice address
3504 W GENESEE ST, SYRACUSE, NY 13219-2008
(315) 350-3305
Mailing address
121 JORDAN ST, SKANEATELES, NY 13152-1113
(315) 391-1281
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006151
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02208226
—
NY
Enumeration date
11/17/2005
Last updated
03/17/2018
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