Individual
MRS. THERESA MARY HUMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5011
Mailing address
123 NORTHWOOD WAY, CAMILLUS, NY 13031-1261
(315) 468-1288
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F332293-1
NY
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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