Individual
JORGE DAVID ALVARENGA MONTOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
436 HINSDALE RD, CAMILLUS, NY 13031-1648
(315) 488-0996
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
319369
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2019
Last updated
09/21/2022
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