Individual
AMY LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5417 W GENESEE ST STE 3, CAMILLUS, NY 13031-2177
(315) 476-2323
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012926
NY
Other
Enumeration date
12/03/2008
Last updated
10/07/2024
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