Individual
MRS. LAUREN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2306
(315) 464-9638
Mailing address
5817 INNSBRUCK RD, EAST SYRACUSE, NY 13057-3056
(315) 656-3892
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005142-1
NY
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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