Individual
MICHAEL SANAVONXAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN BSN
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-3600
Mailing address
706 STINARD AVE, SYRACUSE, NY 13207-1508
(315) 480-1002
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
961451
NY
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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