Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE L CASS (NURSE PRACTITIONER)
(315) 425-4891
Entity
Organization
Contact information
Practice address
211 CHURCHILL LN, FAYETTEVILLE, NY 13066-2538
(315) 637-3841
Mailing address
800 IRVING AVE, SYRACUSE, NY 13210-2716
(315) 425-4400
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
F302090
NY
Other
Enumeration date
07/29/2006
Last updated
08/22/2020
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