Individual
CLINTON INGERSOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
739 IRVING AVE STE 450, SYRACUSE, NY 13210-1663
(315) 470-7364
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3433
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
326196
NY
208600000X
Surgery Physician
LT20455
ND
Other
Enumeration date
03/20/2017
Last updated
01/11/2024
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