Individual
DR. VIRGINIA ALLDREDGE TRACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5824 WIDEWATERS PKWY STE 4, EAST SYRACUSE, NY 13057-3072
(315) 500-7546
(315) 378-4210
Mailing address
5824 WIDEWATERS PKWY STE 4, EAST SYRACUSE, NY 13057-3072
(315) 500-7546
(315) 378-4210
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
295881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
295881
NYS LICENSE
NY
Enumeration date
05/01/2013
Last updated
11/05/2020
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