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Individual

AMANDA M MARKHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5535
(315) 492-5222
Mailing address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5535
(315) 492-5222

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F335656
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03056200
NY
01
P00869152
RAILROAD MEDICARE
NY
Enumeration date
09/17/2008
Last updated
03/20/2015
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