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Individual

IMAD S NSOULI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 IRVING AVE, SYRACUSE, NY 13210-2716
(315) 425-2636
(315) 425-2639
Mailing address
800 IRVING AVE, SYRACUSE, NY 13210-2716
(315) 425-2636
(315) 425-2639

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
148367-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02891427
NY
Enumeration date
06/17/2006
Last updated
10/21/2010
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