Individual
BLAKE SYDNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 MADISON ST, SYRACUSE, NY 13210-2319
(315) 426-3600
Mailing address
10 GRAYHILL CT, LIVERPOOL, NY 13090-3919
(315) 600-0036
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
699874
NY
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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