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Individual

EDWARD J WYLUDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
5008 BRITTONFIELD PKWY STE 700, EAST SYRACUSE, NY 13057
(315) 472-7504
(315) 634-4677
Mailing address
5008 BRITTONFIELD PKWY STE 700, EAST SYRACUSE, NY 13057-9249
(315) 472-7504
(315) 634-4677

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT014151
PA
207RH0003X
Hematology & Oncology Physician
Primary
289014
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
289014
NYS LICENSE
NY
Enumeration date
05/25/2011
Last updated
07/21/2022
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