Organization
JOHN R. WANAMAKER, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RAYMOND WANAMAKER MD (MD)
(315) 632-7000
Entity
Organization
Contact information
Practice address
5100 W TAFT RD, STE 3A, LIVERPOOL, NY 13088-3807
(315) 632-7000
(315) 632-7010
Mailing address
5100 W TAFT RD, STE 3A, LIVERPOOL, NY 13088-3807
(315) 632-7000
(315) 632-7010
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
980213000640
NY
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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