Individual
DR. ANDREW P HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 BRITTONFIELD PKWY STE A100, EAST SYRACUSE, NY 13057-9227
(315) 449-3800
(315) 449-0558
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3433
(315) 449-0558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
264018
NY
207R00000X
Internal Medicine Physician
Primary
264018-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03566525
—
NY
Enumeration date
03/05/2013
Last updated
03/12/2021
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