Individual
ANDREW JOHN CARL NOTTELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
116 MARSDEN RD, SYRACUSE, NY 13208-3313
(315) 657-5861
Mailing address
116 MARSDEN RD, SYRACUSE, NY 13208-3313
(315) 657-5861
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290626
NY
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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