Individual
MISS FAIDA BEATRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 JASPER ST, SYRACUSE, NY 13203-1557
(323) 896-9401
Mailing address
144 JASPER ST, SYRACUSE, NY 13203-1557
(323) 896-9401
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
133036773
NY
Other
Enumeration date
01/04/2022
Last updated
01/19/2022
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