Individual
KRISTINE P. SIDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
400 WALBERTA RD, SYRACUSE, NY 13219-2214
(315) 426-3200
Mailing address
400 WALBERTA RD, SYRACUSE, NY 13219-2214
(315) 426-3200
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01366623
—
NY
Enumeration date
07/13/2011
Last updated
07/13/2011
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