Individual
WANDA FREMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-3175
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-3175
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
158994
NY
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
158994
NY
Other
Enumeration date
06/16/2006
Last updated
07/11/2007
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