Organization
CENTRAL NEW YORK FAMILY HEALTH NURSE PRACTITIONER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIDZY LYSIUS FNP (CEO)
(315) 876-5748
Entity
Organization
Contact information
Practice address
5701 E. CIRCLE DR., #264 SUITE 108, CICERO, NY 13039
(315) 876-5748
Mailing address
6303 YULEWOOD CIR, CICERO, NY 13039-9251
(315) 876-5748
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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