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Individual

MR. AFIX FAMOSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4443 CLEVELAND RD, SYRACUSE, NY 13215-2419
(347) 257-6706
Mailing address
1100 IVY RIDGE RD APT 31, SYRACUSE, NY 13210-4129
(347) 257-6706

Taxonomy

Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
320092
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
404140
NY

Other

Enumeration date
06/12/2015
Last updated
04/15/2024
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